Abstract |
Objective: To describe the hospital burden and health outcomes associated
with admission for congestive heart failure (CHF).
Design: Descriptive follow-up study.
Setting: Tertiary level metropolitan teaching hospital.
Patients: Acute adult inpatients with a clinical diagnosis of CHF for a
period exceeding 24 hours, admitted to Westmead Hospital, Sydney during the 4 months from
September 1993 to January 1994. At baseline, 122 patients were assessed; 88 patients were
assessed at 4 month follow-up.
Interventions: Usual clinical care.
Main outcome measures: Length of stay, hospital bed days, readmissions,
mortality, health related quality of life (SF-36), patient knowledge.
Results: The average age of subjects was 73.4 years. Many were using
informal domiciliary care before admission. During the baseline admission period, mean
length of stay was 13.8 days accounting for 1683 hospital bed days or 4.2% of bed days for
all inpatients aged 65 years and over. 15 patients were readmitted for CHF during the 4 month
follow-up period, with a total of 26 CHF-related admissions. Twenty one patients (17.2%)
died during the course of the study. Quality of life at baseline was poor compared with
population normative data, with slight improvement among survivors at 4 month follow-up.
Patient knowledge of CHF was poor in a subsample survey (n= 24).
Conclusions: Chronic CHF represents a significant burden to patients
(through morbidity and mortality), their carers (through provision of daily care), and (through
multiple admissions for acute decompensation). It is difficult to monitor the hospital burden
of CHF using routine data sources.Introduction
©MJA 1997
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© MJA 1997
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