OBJECTIVES: Heart failure (HF) is associated with substantial morbidity and high rates of hospital readmission. However, few data assess the trends overtime of readmission, mortality, emergency use and pattern of drug use. The study objectives are to assess the incidence rate of HF hospital readmission, mortality, all-cause emergency visits (ER) and pattern of drug use in 12 months following hospital admission of HF incident cases from 1997 to 2010.

METHODS: We used a cohort of HF incident cases being hospitalized for a primary diagnosis of HF and discharge in community from 1997 to 2010. Linked Quebec administrative health care databases were analyzed to estimate incidence rate of HF readmission, mortality and ER stratified by sex in the 12-month period following discharge. We reported data as rates per 100,000 persons and age standardized. We assess the pattern of drug use in a 3-month period after discharge.

RESULTS: A cohort of 12,807 HF patients with median age of 71 years, ischemic heart disease (56%), atrial fibrillation (35%), diabetes (34%), MPOC (30%) and hypertension (23%). Among men, age-standardized incidence rate of readmission and mortality rate within 12-month period varied from 2,506 to 1,505 per 100,000 and from 2,522 to 1,079 per 100,000, respectively. Overall annual mortality rate was close 10%. Age-standardized ER rate increased from 7,850 to 9,497 per 100,000 for men. Lower values were noted for women. Significant changes were seen for β-blockers and renin-angiotensin inhibitors overtime.

CONCLUSIONS: Patients seeking care for HF hospital admission seen overtime a reduction of readmission and mortality but increase in ER rate in the next 12- month period.