TY - JOUR
T1 - Prevalence of Heart Failure and Adherence to Process Indicators: Which Socio-Demographic Determinants are Involved?
AU - Buja, Alessandra
AU - Solinas, Giuliana
AU - Visca, Modesta
AU - Federico, Bruno
AU - Gini, Rosa
AU - Baldo, Vincenzo
AU - Francesconi, Paolo
AU - Sartor, Gino
AU - Bellentani, Mariadonata
AU - Bellentani, Maria Donata
AU - Damiani, Gianfranco
PY - 2016
Y1 - 2016
N2 - 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.
AB - 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.
KW - health care research
KW - inequalities
KW - primary health care
KW - quality of care
KW - health care research
KW - inequalities
KW - primary health care
KW - quality of care
UR - http://hdl.handle.net/10807/76370
UR - http://www.mdpi.com/1660-4601/13/2/238
U2 - 10.3390/ijerph13020238
DO - 10.3390/ijerph13020238
M3 - Article
SN - 1660-4601
VL - 13
SP - E238-N/A
JO - International Journal of Environmental Research and Public Health
JF - International Journal of Environmental Research and Public Health
ER -