AHA: Fewer Medicare patients hospitalized for cardiac causes

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Cardiac problems remain a persistent concern for Medicare beneficiaries; however, rates for cardiac-related hospitalizations have declined over the past decade, according to new data presented at this year’s annual American Heart Association (AHA) Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke scientific sessions in Atlanta.

To better understand the trends of hospitalization for Medicare beneficiaries, Amit H. Sachdev, MD, the study’s lead author and his colleagues from the Yale Centers for Outcomes Research and Evaluation (CORE) in New Haven, Conn., reviewed data of 11 million Medicare beneficiaries who were hospitalized in 1998 from any cause.

“Smaller proportions of U.S. elderly are being hospitalized for six of the eight leading causes of hospitalizations,” Sachdev told Cardiovascular Business. “We found the rate of decline and proportion of elderly Americans hospitalized for cardiac causes to be greater than the rate of decline for non-cardiac causes.”

Coronary artery disease (CAD) saw the greatest drop, 538,749 admissions in 1998 to 409,763 admissions in 2008. Hospital admissions for MI saw the second-largest decline, from 358,251 in 1998 to 311,276 by 2008.

Additionally, Sachdev noted that hospital admissions fell:

  • 31.7 percent for CAD;
  • 22.2 percent for MI; and
  • 16.8 percent for heart failure.

 
However, while these decreases were significant, the researchers also found that the rates of hospitalization for cardiac arrhythmias increased 10.5 percent between 1998 and 2008.

Hospital admissions for pneumonia, electrolyte disorders and hip fracture decreased but at a slower decline in comparison to cardiac-related hospitalizations. Hospitalizations for the aforementioned conditions fell at rates of 18.9 percent, 14.5 percent and 11.6 percent, respectively.

“We don’t know why exactly we observed these trends,” Sachdev offered. “We can speculate that one of the main reasons could be due to the significant amount of money that the government has invested in treating and preventing cardiac diseases.”

More research for MI including the use of troponin testing, and the development and administration of cardiac medications, such as ACE inhibitors and beta-blockers, can help better prevent and treat cardiac disease.

Sachdev estimated that the elderly patient population will double between 2015 and 2030. “This could lead to a higher rate of elderly Americans being hospitalized; however, based on this analysis, hospitalizations may not be as high for cardiac causes as compared with non-cardiac causes,” Sachdev noted.

Even while these hospitalization rates are on the decline, Sachdev said that increased efforts are still needed to further promote awareness and prevention of cardiac diseases. “We still need to educate patients and doctors on how to best treat cardiac diseases,” Sachdev offered. He said that the addition of heart failure clinics has improved both the rates of hospitalizations and readmissions, but more efforts are necessary.

“We also will need to increase the awareness and research funding that goes into treating cardiac disease whether with the help of pharmaceutical or device companies,” Sachdev concluded. “We are doing this today, but we still have a long way to go.”

Sachdev recommended that patients and physicians collaborate to learn how to prevent or manage heart disease.

The study was funded by the National Heart, Lung and Blood Institute.