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Int. J. Environ. Res. Public Health 2016, 13(2), 238; doi:10.3390/ijerph13020238

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

1
Laboratory of Public Health and Population Studies, Department of Molecular Medicine, University of Padova, 35122 Padova, Italy
2
Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
3
Agenas, National Agency for Health Services, 00187 Rome, Italy
4
Department of Human Sciences, Social and Health, University of Cassino and Southern Lazio, 03043 Cassino, Italy
5
Regional Health Agency of Tuscany, 50141 Firenze, Italy
6
Faculty of Medicine, University of Padova, 35122 Padova, Italy
7
Department of Public Health, Università Cattolica del Sacro Cuore in Rome, 00168 Rome, Italy
VALORE project for the evaluation of Primary Care.
*
Author to whom correspondence should be addressed.
Academic Editor: Harry H.X. Wang
Received: 24 September 2015 / Revised: 22 January 2016 / Accepted: 3 February 2016 / Published: 19 February 2016
(This article belongs to the Special Issue Chronic Diseases and Multimorbidity in Primary Care)
View Full-Text   |   Download PDF [756 KB, uploaded 22 February 2016]   |  

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. View Full-Text
Keywords: primary health care; health care research; quality of care; inequalities primary health care; health care research; quality of care; inequalities
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Buja, A.; Solinas, G.; Visca, M.; Federico, B.; Gini, R.; Baldo, V.; Francesconi, P.; Sartor, G.; Bellentani, M.; Damiani, G. Prevalence of Heart Failure and Adherence to Process Indicators: Which Socio-Demographic Determinants are Involved? Int. J. Environ. Res. Public Health 2016, 13, 238.

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