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25 years after the fall of the wall - still substantial regional differences in hospitalization for heart failure between eastern and western Germany

Session Moderated Poster Session 7 - Multidisciplinary team: innovation in care and management

Speaker Stefan Stoerk

Event : Heart Failure 2015

  • Topic : e-cardiology / digital health, public health, health economics, research methodology
  • Sub-topic : Research Methodology
  • Session type : Moderated Posters

Authors : S Stork (Wurzburg,DE), M Christ (Nuremberg,DE), H-J Heppner (Witten,DE), C Muller (Basel,CH), M Dorr (Greifswald,DE), U Riemer (Nuremberg,DE), R Wachter (Gottingen,DE)

Authors:
S Stork1 , M Christ2 , H-J Heppner3 , C Muller4 , M Dorr5 , U Riemer6 , R Wachter7 , 1University Hospital of Wurzburg, Department of Internal Medicine I and Comprehensive Heart Failure Center - Wurzburg - Germany , 2Paracelsus Medical University, Department of Emergency and Intensive Care Medicine - Nuremberg - Germany , 3University of Witten/Herdecke, Department of Geriatrics, HELIOS Klinikum Schwelm, University of Witten - Witten - Germany , 4University Hospital Basel, Department of Internal Medicine - Basel - Switzerland , 5University Medicine of Greifswald, Clinic of Internal Medicine B - Greifswald - Germany , 6Novartis Pharma GmbH, Medical Affairs - Nuremberg - Germany , 7University Hospital Gottingen, Clinic for Cardiology and Pneumology, DZHK - Gottingen - Germany ,

On behalf: Trends HF Germany Project

Citation:
European Journal of Heart Failure Abstracts Supplement ( 2015 ) 17 ( Supplement 1 ), 379

Background: Heart failure (HF) is a major cause of hospitalization in subjects aged over 65 in the western world. Morbidity and mortality remain high, and the prevalence of HF is still increasing, reflecting demographic changes, detrimental lifestyle habits, and medical progress. We analyzed temporal trends in HF hospitalization and in-hospital (i-h) death in Germany between 2000 and 2013 with a focus on regional differences.Methods: The analyses are based on the German Federal Health Monitoring System, an annual census of inpatient characteristics in all German hospitals provided by the Federal Statistical Office. Data collection is statutory, and uniform criteria for diagnosis were applied throughout the period of examination.

Results: The number of HF related hospitalizations in Germany increased continuously from 239,694 in 2000 to 396,165 cases in 2013 (+ 65%). The New Länder (NL) showed a more pronounced increase (79%) compared to the Old Länder (OL; 57%).Between 2000 and 2012, HF expanded its share in total hospitalization from 1.40 to 2.03%, which represents a relative growth of 45%. As a result, HF today represents the leading cause of disease-related hospitalization in Germany. The relative growth in NL was 61% (from 1.50 to 2.43% of all hospitalizations) and more pronounced than in OL (42%; from 1.38 to 1.98%).Consistently, in an age-standardized chart, the number of admissions for HF per 100,000 population was higher in NL (393) than in OL (313); in subjects aged ≥65, the resp. numbers were 2,212 (NL) vs. 1,815 per 100,000 population (OL).Despite a continuous reduction in mean length of stay (from 14.3 to 10.7 days; -25%), the absolute number of hospital days due to HF rose by 21%. In 2012, HF accounted for 4.13 million hospital days making it the second leading cause of days spent in the hospital, causal for 3% of total occupant days. The number of hospital days due to HF increased by 31% in NL vs. 18% in OL.The absolute number of i-h deaths attributable to HF was constantly high at 35,000 per year. In 2012, i-h mortality rate in HF patients was 9.2% (NL: 9.4%, OL: 9.2%). HF was by far the leading cause of i-h death responsible for 8.8% of total i-h mortality, with a persistently and substantially higher share in NL compared to OL (2012: 10.2% vs. 8.5%).Conclusion: HF has become the leading cause of disease-related hospital admission and i-h death in Germany. Key morbidity and mortality indicators are more pronounced in NL compared to OL. The increasing burden of HF underscores an urgent need for improved diagnostic, therapeutic, and preventive strategies.

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