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Heart failure study: Hospital stays down

CHICAGO -- Hospital stays for heart failure fell a remarkable 30 percent in Medicare patients over a decade, the first such decline in the United States and forceful evidence that the nation is making headway in reducing the billion-dollar burden of a common condition.

But the study of 55 million patients, the largest ever on heart failure trends, found only a slight decline in deaths within a year of leaving the hospital, and progress lagged for black men.

"Certain populations haven't seen the full benefit of that decrease," said lead author Dr. Jersey Chen of Yale University School of Medicine.

Possible explanations for the decline in hospital stays include healthier hearts, better control of high blood pressure and more treated in emergency rooms and clinics without being admitted to hospitals, said Dr. Mariell Jessup of the Penn Heart and Vascular Center in Philadelphia.

"I think it's extraordinary news," said Jessup, who wasn't involved in the new research.

More than 5 million Americans and 22 million people globally have heart failure. Their hearts strain to pump blood because of damage, often from a heart attack or from high blood pressure. Fluid backing up into the lungs can leave people struggling to breathe.

Heart failure is the most common cause of hospitalization in older patients, so fewer hospital stays save a lot of money.

From 1998 to 2008, the rate fell from 2,845 hospitalizations per 100,000 Medicare beneficiaries to 2,007 per 100,000, research reported in today's Journal of the American Medical Association shows.

If the rate had remained the same, 229,000 more heart failure hospital stays in 2008 would have cost Medicare an additional $4.1 billion, Chen said.

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