Prevalence of Heart Failure and Adherence to Process Indicators: Which Socio-Demographic Determinants are Involved?

Gianfranco Damiani, Modesta Visca, Bruno Federico, Maria Donata Bellentani, Alessandra Buja, Giuliana Solinas, Rosa Gini, Vincenzo Baldo, Paolo Francesconi, Gino Sartor, Mariadonata Bellentani

Risultato della ricerca: Contributo in rivistaArticolo in rivista

11 Citazioni (Scopus)

Abstract

Interest in chronic conditions reflects their role as the first cause of death and disability in developed countries; improving the management of these conditions is a priority for health care services. The aim of this study was to establish which sociodemographic factors influence adherence to standards of care for chronic heart failure (CHF). A generalized multilevel structural equation model was developed and applied to a sample of patients with CHF obtained from administrative data flows in six Italian regions to ascertain any associations between adherence to standards of care for CHF and sociodemographic variables. Indicators of compliance were adherence to beta-blocker therapy (BB-A) and Angiotensin Convertin Enzime inhibitor/Angiotensin Receptor Blocker therapy (ACE-A), and creatinine and electrolyte testing (CNK-T). All indicators were computed over a one-year follow-up. Among a cohort of 24,997 patients, the BB-A rate was 40.4%, the ACE-A rate 61.1%, and the CNK-T rate 57.0%. Factors found associated with adherence were gender, age, and citizenship. Our study shows an inadequate adherence to standards of care for CHF, particularly associated with certain sociodemographic characteristics. This suggests the need to improve the role of primary care in managing this chronic condition. The measures considered only apply to patients with a reduced Left Ventricular Ejection Fraction, hence a limitation of this analysis is the lack of information on left ventricular ejection.
Lingua originaleEnglish
pagine (da-a)E238-N/A
RivistaInternational Journal of Environmental Research and Public Health
Volume13
DOI
Stato di pubblicazionePubblicato - 2016

Keywords

  • health care research
  • inequalities
  • primary health care
  • quality of care

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