Does the United States Economy Affect Heart Failure Readmissions? A Single Metropolitan Center Analysis

Abstract

Background:

To determine the effects of the US economy on heart failure hospitalization rates.

Hypothesis:

The recession was associated with worsening unemployment, loss of private insurance and prescription medication benefits, medication nonadherence, and ultimately increased rates of hospitalization for heart failure.

Methods:

We compared hospitalization rates at a large, single, academic medical center from July 1, 2006 to February 28, 2007, a time of economic stability, and July 1, 2008 to February 28, 2009, a time of economic recession in the United States.

Results:

Significantly fewer patients had private medical insurance during the economic recession than during the control period (36.5% vs 46%; P = 0.04). Despite this, there were no differences in the heart failure hospitalization or readmission rates, length of hospitalization, need for admission to an intensive care unit, in-hospital mortality, or use of guideline-recommended heart failure medications between the 2 study periods.

Conclusions:

We conclude that despite significant effects on medical insurance coverage, rates of heart failure hospitalization at our institution were not significantly affected by the recession. Additional large-scale population-based research is needed to better understand the effects of fluctuations in the US economy on heart failure hospitalization rates. Clin. Cardiol. 2012 DOI: 10.1002/clc.21996

The authors have no funding, financial relationships, or conflicts of interest to disclose.