Chartbook on Effective Treatment

Adult Admissions for Congestive Heart Failure

Adult admissions for congestive heart failure per 100,000 population, by area income, 2000-2012

2008 Achievable Benchmark: 195 Admissions per 100,000 Population.

Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, Nationwide Inpatient Sample and AHRQ Quality Indicators, version 4.4, 2000-2012.
Denominator: U.S. resident population age 18 and over.
Note: For this measure, lower rates are better. Area income is based on the median income of a patient’s ZIP Code of residence.

• Importance: Some hospitalizations for heart failure are unavoidable, but rates of hospitalization can be influenced by the quality of outpatient care.
• Trends: From 2000 to 2012, the rate of admission for congestive heart failure among adults decreased significantly overall and for all area income groups.
• Groups With Disparities: In all years, compared with residents in the highest area income quartile, rates of admission for congestive heart failure were higher among residents in the lowest and second area income quartiles.
• Achievable Benchmark:
  • The 2008 top 4 State achievable benchmark for adult congestive heart failure admissions was 195 admissions per 100,000 population. The top 4 States that contributed to the achievable benchmark are Colorado, Oregon, Utah, and Vermont.
  • At current rates of improvement, residents in the highest area income quartile could achieve the benchmark in 5 years while residents in the lowest area income quartile would need 12 years.

Adult Admissions for Congestive Heart Failure

Adult admissions for congestive heart failure per 100,000 population, by race/ethnicity, 2001-2012

2008 Achievable Benchmark: 195 Admissions per 100,000 Population.

Key: API = Asian or Pacific Islander.
Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, State Inpatient Databases, disparities analysis files and AHRQ Quality Indicators, version 4.4, 2001-2012.
Denominator: U.S. resident population age 18 and over.
Note: For this measure, lower rates are better. White and Black are non-Hispanic. Hispanic includes all races.

• Importance: Racial disparities in care for congestive heart failure have been observed.
• Trends: From 2001 to 2012, the rate of admission for congestive heart failure among adults decreased significantly for all racial/ethnic groups.
• Groups With Disparities: In all years, compared with White patients, rates of admission for congestive heart failure were higher among Black patients and lower among API patients.
• Achievable Benchmark:
  • The 2008 top 4 State achievable benchmark for adult congestive heart failure admissions was 195 admissions per 100,000 population. The top 4 States that contributed to the achievable benchmark are Colorado, Oregon, Utah, and Vermont.
  • By 2012, Asian and Pacific Islander (API) patients had reached the benchmark.
  • At current rates of improvement, Hispanic patients could achieve the benchmark in 3 years and White patients could achieve it in 6 years. Black patients would need 12 years to achieve the benchmark.

Adult Admissions for Congestive Heart Failure

Adult admissions for congestive heart failure per 100,000 population, State of Hawaii, by granular ethnicity, 2010-2011

2008 Achievable Benchmark: 195 Admissions per 100,000 Population.

Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, Hawaii State Inpatient Databases and AHRQ Quality Indicators, modified version 4.1, 2010-2011.
Denominator: Adults age 18 and over in Hawaii based on the Hawaii Health Survey.
Note: For this measure, lower rates are better. Rates are adjusted by age and gender using the total U.S. population for 2000 as the standard population.

• Importance:
  • The ability to assess disparities among Native Hawaiians and Other Pacific Islanders (NHOPIs) has been a challenge for two main reasons:
    • First, the NHOPI racial category is relatively new to Federal data collection. Before 1997, NHOPIs were classified as part of the API racial category and could not be identified separately in most Federal data. In 1997, the Office of Management and Budget promulgated new standards for Federal data on race and ethnicity and mandated that information about NHOPIs be collected separately from information about Asians. However, these standards have not yet been incorporated into all databases.
    • Second, when information about this population was collected, databases often included insufficient numbers of NHOPIs to allow reliable estimates to be made.
  • Hawaii, home to more than half of Native Hawaiians in the United States, is a leader in collecting health information on NHOPI and Asian populations.
• Groups With Disparities: In Hawaii, in both years, Native Hawaiians, Samoans, Other Pacific Islanders, and Filipinos had higher rates of hospital admission for congestive heart failure than Whites.
• Achievable Benchmark:
  • The 2008 top 4 State achievable benchmark for adult congestive heart failure admissions was 195 admissions per 100,000 population. The top 4 States that contributed to the achievable benchmark are Colorado, Oregon, Utah, and Vermont.
  • In Hawaii, Whites, Chinese people, Japanese people, and Koreans have achieved the benchmark while Native Hawaiians, Samoans, Other Pacific Islanders, and Filipinos have not.

Costs of Hospitalizations for Congestive Heart Failure

Total national costs of hospitalizations for congestive heart failure, 2000-2012

Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, Nationwide Inpatient Sample and AHRQ Quality Indicators, version 4.4, 2000-2012.
Denominator: U.S. resident population age 18 and over.
Note: For this measure, lower rates are better. Annual rates are adjusted for age and sex. Costs are adjusted for inflation and are represented in 2012 dollars.

• Importance: Congestive heart failure is one of the most costly conditions treated in U.S. hospitals.
• Trends: After peaking in 2002, costs have fallen from $9.0 to $7.2 billion in 2012 dollars.

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