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Leading causes of cardiovascular hospitalization in 8.45 million US veterans
Nirupama Krishnamurthi1,2, Joseph Francis3, Stephan D Fihn4
1Veterans Affairs Medical Center, San Francisco, California, United States of America.
Insights
Cardiovascular hospitalizations among U.S. veterans show significant variations by demographics and region. Older, male, Black, non-Hispanic, and urban veterans faced higher hospitalization rates, highlighting disparities in cardiovascular care.
Area of Science:
- Cardiovascular disease epidemiology
- Health services research
- Veterans health administration
Background:
- Cardiovascular (CV) hospitalizations represent a significant healthcare burden.
- Understanding leading causes and disparities in CV hospitalizations is crucial for targeted interventions.
Purpose of the Study:
- To identify the primary causes of cardiovascular hospitalization among U.S. veterans.
- To analyze and compare national rates of cardiovascular hospitalization based on various demographic and regional factors.
Main Methods:
- Evaluation of electronic health records for over 8.4 million U.S. veterans (aged ≥18) from 2010-2014.
- Identification of the top 5 causes of cardiovascular hospitalization.
- Comparison of hospitalization rates across age, gender, race, ethnicity, region, and healthcare utilization patterns.
Main Results:
- The top 5 causes were coronary atherosclerosis, heart failure, acute myocardial infarction, stroke, and atrial fibrillation.
- Overall cardiovascular hospitalization rates decreased slightly from 2010 to 2014, but with significant variations.
- Older, male, Black, non-Hispanic, and urban veterans exhibited higher rates of cardiovascular hospitalization.
Conclusions:
- Significant disparities in cardiovascular hospitalization rates exist among U.S. veterans based on demographics and geography.
- These findings underscore the need for tailored strategies to address cardiovascular health inequities within the veteran population.
Background:
We sought to determine the leading causes of cardiovascular (CV) hospitalization, and to describe and compare national rates of CV hospitalization by age, gender, race, ethnicity, region, and year, among U.S. veterans.
Methods:
We evaluated the electronic health records of all veterans aged ≥18 years who had accessed any healthcare services at either a VA healthcare facility or a non-VA healthcare facility that was reimbursed by the VA, between January 1 2010 and December 31 2014. Among these 8,452,912 patients, we identified the 5 leading causes of CV hospitalization and compared rates of hospitalization by age, gender, race, ethnicity, region, year and type of VA healthcare user.
Results:
The top 5 causes of CV hospitalization were: coronary atherosclerosis, heart failure, acute myocardial infarction, stroke and atrial fibrillation. Overall, 297,373 (3.5%) veterans were hospitalized for one or more of these cardiovascular conditions. The percentage of veterans hospitalized for one or more of these CV conditions decreased over time, from 1.23% in 2010 to 1.18% in 2013, followed by a slight increase to 1.20% in 2014. There was significant variation in rates of CV hospitalization by gender, race, ethnicity, geographic region, and urban vs. rural zip code. In particular, older, male, Black, non-Hispanic, urban and Continental region veterans experienced the highest rates of CV hospitalizations.
Conclusions:
Among 8.5 million patients enrolled in the VA healthcare system from 2010 to 2014, there was substantial variation in rates of CV hospitalization by age, gender, race, geographical distribution, year, and use of non-VA (vs. VA only) healthcare care facilities.
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