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      National Differences in Trends for Heart Failure Hospitalizations by Sex and Race/Ethnicity

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          Abstract

          <div class="section"> <a class="named-anchor" id="S1"> <!-- named anchor --> </a> <h5 class="section-title" id="d9670136e183">Background</h5> <p id="P1">National heart failure (HF) hospitalization rates have not been appropriately age-standardized by sex or race/ethnicity. Reporting hospital utilization trends by subgroup is important for monitoring population health and developing interventions to eliminate disparities. </p> </div><div class="section"> <a class="named-anchor" id="S2"> <!-- named anchor --> </a> <h5 class="section-title" id="d9670136e188">Methods and Results</h5> <p id="P2">The National Inpatient Sample (NIS) was used to estimate the crude and age-standardized rates of HF hospitalization between 2002 and 2013 by sex and race/ethnicity. Direct standardization was used to age-standardize rates to the 2000 U.S. standard population. Relative differences between subgroups were reported. The national age-adjusted HF hospitalization rate decreased 30.8% from 526.86 to 364.66 per 100,000 between 2002 and 2013. While hospitalizations decreased for all subgroups, the ratio of the age-standardized rate for males compared to females increased from 20% greater to 39% (p-for-trend=0.002) between 2002 and 2013. Black males had a rate that was 229% (p-for-trend=0.141) and black females 240% (p-for-trend=0.725) with reference to whites in 2013 with no significant change between 2002 and 2013. Hispanic males had a rate that was 32% greater in 2002 and the difference narrowed to 4% (p-for-trend=0.047) greater in 2013 relative to whites. For Hispanic females the rate was 55% greater in 2002 and narrowed to 8% greater (p-for-trend=0.004) in 2013 relative to whites. Asian/Pacific Islander (PI) males had a 27% lower rate in 2002 that improved to 43% (p-for-trend=0.040) lower in 2013 relative to whites. For Asian/PI females the hospitalization rate was 24% lower in 2002 and improved to 43% (p-for-trend=0.021) lower in 2013 relative to whites. </p> </div><div class="section"> <a class="named-anchor" id="S3"> <!-- named anchor --> </a> <h5 class="section-title" id="d9670136e193">Conclusions</h5> <p id="P3">National HF hospitalization rates have decreased steadily over the recent decade. Disparities in HF burden and hospital utilization by sex and race/ethnicity persist. Significant population health interventions are needed to reduce the HF hospitalization burden among blacks. The evaluation of factors explaining the improvements in the HF hospitalization rates among Hispanics and Asian/PI are needed. </p> </div>

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          Author and article information

          Journal
          Circulation: Cardiovascular Quality and Outcomes
          Circ Cardiovasc Qual Outcomes
          Ovid Technologies (Wolters Kluwer Health)
          1941-7705
          1941-7713
          June 27 2017
          June 27 2017
          : 10
          : 7
          : e003552
          Article
          10.1161/CIRCOUTCOMES.116.003552
          5540644
          28655709
          7e9965f8-f765-4124-a40c-08e5c055572a
          © 2017
          History

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