Trends in Avoidable Hospitalizations for Heart Failure in Switzerland (1998-2018): A Cross-Sectional Analysis

Area of Science:

• Cardiology
• Public Health
• Health Services Research

Background:

• Potentially avoidable hospitalizations (PAHs) for heart failure (HF) represent a significant burden on healthcare systems.
• Effective outpatient care is key to preventing unnecessary hospital admissions for HF patients.

Purpose of the Study:

• To analyze trends, determinants, and consequences of PAHs for HF in Switzerland over a 20-year period (1998-2018).
• To assess the evolving patient demographics and admission characteristics for HF PAHs.

Main Methods:

• Utilized Swiss hospital discharge data from 1998 to 2018.
• Defined PAHs for HF using Organization for Economic Cooperation and Development (OECD) criteria.
• Analyzed admission rates, patient demographics, comorbidity (Charlson index), admission routes, ICU use, length of stay, and associated costs.

Main Results:

• HF PAHs increased significantly, with age-standardized admission rates rising from 107.8 to 220.7 per 100,000 inhabitants between 1999 and 2018.
• Patients admitted for HF PAHs became older and more frequently presented with less severe comorbidity, higher emergency admission rates, and increased self-initiated admissions.
• In 2018, HF PAHs cost over CHF 170 million and occupied 407 beds annually, despite a decrease in length of stay.

Conclusions:

• The incidence of PAHs for HF in Switzerland has shown a consistent upward trend.
• There is a substantial and increasing medical and financial burden associated with HF PAHs.
• Timely and appropriate outpatient care interventions hold significant potential for reducing HF PAHs and their associated costs.