Document Detail


Trends in Hospitalizations and Outcomes for Acute Cardiovascular Disease and Stroke: 1999-2011.
MedLine Citation:
PMID:  25135276     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: -The past decade focused intensely on improving the quality of care for people with, or at risk for, cardiovascular disease and stroke. We sought to quantify the changes in hospitalization rates and outcomes during this period.
METHODS AND RESULTS: -We used national Medicare data to identify all Fee-For-Service patients aged ≥65 years hospitalized with unstable angina, myocardial infarction, heart failure, ischemic stroke, and all other conditions from 1999 through 2011 (2010 for 1-year mortality). For each condition, we examined trends in adjusted rates of hospitalization per patient-year and, for each hospitalization, rates of 30-day mortality, 30-day readmission, and 1-year mortality overall and by demographic subgroups and regions. Rates of adjusted hospitalization declined for cardiovascular conditions (38.0% for 2011 compared with 1999 [95% CI] [37.2% to 38.8%] for myocardial infarction; 83.8% [83.3% to 84.4%] for unstable angina; 30.5% [29.3% to 31.6% ] for heart failure; and 33.6% [32.9% to 34.4%] for ischemic stroke compared with 10.2% [10.1% to 10.2%] for all other conditions). Adjusted 30-day mortality rates declined 29.4% [28.1% to 30.6%] for myocardial infarction; 13.1% [1.1% to 23.7%] for unstable angina; 16.4% [15.1% to 17.7%] for heart failure; and 4.7% for ischemic stroke [3.0% to 6.4%]. There were also reductions in rates of 1-year mortality and 30-day readmission and consistency in declines among the demographic subgroups.
CONCLUSIONS: -Hospitalizations for acute cardiovascular disease and stroke from 1999 through 2011 declined more rapidly than for other conditions. For these conditions, mortality and readmission outcomes improved.
Authors:
Harlan M Krumholz; Sharon-Lise T Normand; Yun Wang
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-8-18
Journal Detail:
Title:  Circulation     Volume:  -     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2014 Aug 
Date Detail:
Created Date:  2014-8-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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