Congestive heart failure (CHF) – or heart failure – is a chronic and progressive disease that represents one of the major public health problems worldwide in terms of frequency, morbidity, mortality, and impact on healthcare services. It is considered the end-stage of cardiovascular diseases, primarily hypertension, ischemic heart disease, and valvular heart disease.
It is a condition characterized by the heart’s insufficient capacity to supply blood to the body, or the need to increase filling pressure to meet demand. According to the European Society of Cardiology, the essential components of heart failure include symptoms of heart failure, especially dyspnea or weakness, both at rest and during exertion, or dependent edema, and objective evidence of major cardiac dysfunction at rest.
The different case definitions used (clinical criteria or ICD9-CM codes) make it difficult to compare the results of different studies: the risk of death within one year of heart failure diagnosis varies from 25% to 33%. The short-term mortality rate after hospitalization for heart failure shows some heterogeneity, although it shows a decreasing trend thanks to improved treatment effectiveness.
The “mortality rate within thirty days of hospitalization for congestive heart failure” measure also those deaths that may occur immediately after discharge but could have been prevented by effective hospital care.
The “readmissions within thirty days of hospitalization for congestive heart failure” indicator assesses the quality of both in- and out-of-hospital care by measuring readmissions that occurred within a short period of hospital admission. These readmissions may be due to the onset of complications or a worsening of the patient’s clinical condition that requires readmission.
The outcomes for both indicators are calculated starting from the date of the patient’s hospital admission, which corresponds to the date of admission for CHF.
Attributing the outcome to the hospital does not imply an assessment of the quality of care provided by that facility, but rather of the appropriateness and effectiveness of the care process that begins with the patient’s arrival at that facility.
Treatment of heart failure involves not only correcting symptoms but also delaying the progression of the disease, reducing the need for hospitalization, increasing survival, and improving quality of life. Patients with mild to moderate heart failure (NYHA classes I and II) can be managed at the community level through periodic specialist check-ups, appropriate therapy, and health education programs.
Proper community-based management of patients with heart failure and the development of appropriate outpatient management protocols can reduce the progression of the disease and prevent hospitalization. The “hospitalization for heart failure” indicator
allows us to assess the appropriateness and effectiveness of the community-based management process for this condition.
The values of the indicators may vary between regions and facilities; this phenomenon, in addition to the varying quality of care, may be caused by the heterogeneous distribution, due to case mix, of various risk factors such as age, gender, and the patient’s health.
Your doctor will address your concerns and guide you in making an informed choice about the treatment plan to follow. Contact him or her for all the information you need for your healthcare needs.
Indicators 
