Hospitalization for heart failure in the USA, UK, Taiwan and Japan: an international comparison of administrative health records on 417,385 individual patients

Sundaram, V. et al. (2022) Hospitalization for heart failure in the USA, UK, Taiwan and Japan: an international comparison of administrative health records on 417,385 individual patients. Journal of Cardiac Failure, 28(3), pp. 353-366. (doi: 10.1016/j.cardfail.2021.08.024) (PMID:34634448)

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Abstract

Background : Registries show international variations in the characteristics and outcome of patients with heart failure (HF) but national samples are rarely large, and case-selection may be biased due to enrolment in academic centres. National administrative datasets provide large samples with a low risk of bias. In this study, we compared the characteristics, healthcare resource utilization (HRU) and outcomes of patients with primary HF hospitalizations (HFH) using electronic health records (EHR) from four high-income countries (USA, UK, Taiwan, Japan) on three continents. Methods and Results : We used EHR to identify unplanned HFH between 2012-2014. We identified 231,512, 10,991, 36,900 and 133,982 patients with a primary HFH from USA, UK, Taiwan and Japan, respectively. HFH per 100,000 population was highest in USA and lowest in Taiwan. Patients in Taiwan and Japan were older but fewer were obese or had chronic kidney disease. LOHS was shortest in USA (median 4 days) and longer in UK, Taiwan and Japan (medians 7, 9 and 17 days, respectively). HRU during hospitalization was highest in Japan and lowest in UK. Crude and direct standardized in-hospital mortality was lowest in USA (direct standardized rates: 1.8 [95%CI:1.7-1.9]%)and progressively higher in Taiwan (direct standardized rates: 3.9 [95%CI:3.8-4.1]%), UK (direct standardized rates: 6.4 [95%CI:6.1-6.7]%) and Japan (direct standardized rates: 6.7 [95%CI:6.6-6.8]%). 30-day all-cause (25.8%) and HF (7.2%) readmissions were highest in USA and lowest in Japan (11.9% and 5.1% respectively). Conclusion : Marked international variations in patient characteristics, HRU and clinical outcome exist; understanding them might inform health care policy and international trial design.

Item Type:Articles
Additional Information:Funding: National Institute of Health (NIH 1R21HL140417-01A1), USA; Great Britain Sasakawa Foundation (B114), UK; Japanese Society for the Promotion of Science (JSPS 18K08122), Japan
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Cleland, Professor John
Authors: Sundaram, V., Nagai, T., Chiang, C.-E., Reddy, Y. N.V., Chao, T.-F., Zakeri, R., Bloom, C., Nakai, M., Nishimura, K., Hung, C.-L., Miyamoto, Y., Yasuda, S., Banerjee, A., Anzai, T., Simon, D. I., Rajagopalan, S., Cleland, J. G.F., Sahadevan, J., and Quint, J. K.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:Journal of Cardiac Failure
Publisher:Elsevier
ISSN:1071-9164
ISSN (Online):1532-8414
Published Online:08 October 2021
Copyright Holders:Copyright © 2021 Elsevier Inc.
First Published:First published in Journal of Cardiac Failure 28(3): 353-366
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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