Avoidable Hospital Admissions for Heart Failure, Spain

Background: The avoidable hospital admissions for heart failure are problem for health systems worldwide, as they waste resources, generate additional morbidities and high mortality. The objective of this study was to determine the risk factors in patients hospitalized for heart failure to prevent further unplanned admissions. Methods: A group of medical from Hospital and Primary Care was established. We realized an audit of a sample of 110 patients from Aljarafe towns with highest hospital admissions for heart failure. The analysis used Student T test and Mann Whitney for quantitative variables; lambda(2) test and Fisher exact test for qualitative variables. Results: Patients admitted for HF had a mean age of 78.1 years (SD: 9.56); 73 (66.4%) were women; Barthel Index was 45.0 on average; 53.5% had NYHA class III and 17 (15.5%) were institutionalized, 70% had between 3 and 5 comorbidities, mainly hypertension (87.3%), dyslipidemia (60.0%), diabetes (57.3%), chronic kidney disease (56.4%), anemia (53.2%) or atrial fibrillation (52.7%). During hospitalization, 23 patients (20.9%) died. They were mostly women, elderly, had a previous admission and without beta-blockers treatment. The admission in the last 12 months was associated with identification of the primary caregiver; ischemic HF; revascularization; inclusion in the COMPARTE Program; treatment change decompensation. Conclusions: The hospital admissions were more frequently an aging population with multiple diseases (hypertension, diabetes, COPD, renal disease) and low capacity for basic activities of daily life. The hospital mortality associated with elderly, women, less use of beta-blockers and the non-inclusion of the patient in the care process.