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Who diagnoses and treats patients with chronic heart failure in Germany? A retrospective study of the health risk institute healthcare claims database

Session Poster Session 1

Speaker Stefan Stoerk

Event : Heart Failure 2016

  • Topic : cardiovascular nursing and allied professions
  • Sub-topic : Chronic Nursing Care
  • Session type : Poster Session

Authors : F Calado (Basel,CH), S Stork (Wuerzburg,DE), S Hupfer (Nuernburg,DE), D Souto (Basel,CH), R Handrock (Nuernburg,DE), J Jacob (Berlin,DE), J Walker (Berlin,DE), S Klebs (Nuernburg,DE)

Authors:
F Calado1 , S Stork2 , S Hupfer3 , D Souto1 , R Handrock3 , J Jacob4 , J Walker4 , S Klebs3 , 1Novartis Pharma AG - Basel - Switzerland , 2University of Wuerzburg, Department of Internal Medicine I, Cardiology - Wuerzburg - Germany , 3Novartis Pharma GmbH - Nuernburg - Germany , 4Elsevier - Berlin - Germany ,

Citation:
European Journal of Heart Failure Abstracts Supplement ( 2016 ) 18 ( Supplement 1 ), 46

Background: Little is known about the journey of patients with newly diagnosed chronic heart failure (CHF) in real-world settings in Germany. Therefore, a retrospective study of anonymized healthcare claims data from the Health Risk Institute (HRI) database was conducted. Purpose: The objective was to describe the journey of patients with newly diagnosed CHF in Germany. Methods: Data from patients with at least two recorded CHF-related diagnoses in 2011 (based on ICD-10 German Modification codes for CHF in a hospital or ambulatory setting) were analysed. Further, a subgroup of patients with newly diagnosed CHF was identified based on the absence of a CHF diagnosis in the year before first diagnosis in 2011. All patients were followed for 2 years. Results: CHF was newly diagnosed in 26 368 patients; in 63.2% (n = 16 653) the diagnosis was made by an office-based physician, in 36.6% (n = 9653) the diagnosis was made in a hospital inpatient setting. Among patients diagnosed by an office-based physician, 61.6% (n = 10 254) of diagnoses were made by family practitioners and 21.6% (n = 3595) by specialists in internal medicine; of the latter, 68.5% (n = 2462) of diagnoses were made by cardiologists. A small proportion (7.0%, n = 1171) of first CHF diagnoses were made by an office-based physician outside of family and internal medicine. Among patients with a first CHF diagnosis made in a hospital inpatient setting, 70.7% (n = 6827) of diagnoses were made by internal medicine specialists; 27.3% (n = 1864) of these were made by cardiologists. There was no information available for CHF diagnosed in a hospital outpatient setting. Of patients surviving the first quarter after CHF diagnosis (95.4%, n = 25 155), almost all (98.0%, n = 24 641) were treated in primary care in the same quarter; this proportion remained virtually unchanged after 2 years. Of note, 26.0% (n = 6541) of these patients received additional hospital inpatient care in the first quarter after CHF diagnosis; this decreased to 14.9% after 2 years. A much smaller proportion of patients (4.2%, n = 1058) received hospital outpatient care; this fraction remained almost unchanged after 2 years. Conclusions: These results demonstrate the pivotal role of family practitioners as the primary point of contact in the diagnosis and management of patients with CHF. Close collaboration and communication between all specialities and sectors is essential for providing optimal care for these patients. Further studies are needed to quantify the effectiveness of patient journeys in terms of costs and patient outcome.

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