The purpose of this study was to create an automated surveillance tool for reporting
the incidence, prevalence and processes of care for patients with heart failure.
Previous epidemiologic studies suggest that the increasing prevalence of heart failure
is a consequence of improved survival coupled with minimal changes in disease prevention.
Developing new, efficient methods of assessing the incidence and prevalence of heart
failure could allow continued surveillance of these rates during an era of rapidly
changing treatments and health care delivery patterns.
Using administrative data sets, we created a definition of heart failure using diagnosis
codes. After adjustment for patients leaving our health system or death, we derived
the incidence, prevalence and mortality of the population with heart failure from
1989 to 1999.
A total of 29,686 patients of all ages, 52.6% women and 47.4% men, met the definition
of heart failure. Mean ages were 71.1 +/- 14.5 for women and 67.7 +/- 14.4 for men,
p < 0.0001. Race proportions were 50.5% white, 44.6% African American and 4.9% other
race. Incidence rates were higher in men and African Americans across all age groups.
There was an annual increase in prevalence of 1/1,000 for women and 0.9/1,000 for
men, p = 0.001 for both trends.
Through the feasible and valid use of automated data, we have confirmed a chronic
disease epidemic of heart failure manifested primarily by an increase in prevalence
over the past decade. Our surveillance system mirrors the results of epidemiologic
studies and may be a valid method for monitoring the impact of prevention and treatment
programs.