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

Alessandra Buja, Giuliana Solinas, Modesta Visca, Bruno Federico, Rosa Gini, Vincenzo Baldo, Paolo Francesconi, Gino Sartor, Mariadonata Bellentani and Gianfranco Damiani
Additional contact information
Alessandra Buja: Laboratory of Public Health and Population Studies, Department of Molecular Medicine, University of Padova, 35122 Padova, Italy
Giuliana Solinas: Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
Modesta Visca: Agenas, National Agency for Health Services, 00187 Rome, Italy
Bruno Federico: Department of Human Sciences, Social and Health, University of Cassino and Southern Lazio, 03043 Cassino, Italy
Rosa Gini: Regional Health Agency of Tuscany, 50141 Firenze, Italy
Vincenzo Baldo: Laboratory of Public Health and Population Studies, Department of Molecular Medicine, University of Padova, 35122 Padova, Italy
Paolo Francesconi: Regional Health Agency of Tuscany, 50141 Firenze, Italy
Gino Sartor: Faculty of Medicine, University of Padova, 35122 Padova, Italy
Mariadonata Bellentani: Agenas, National Agency for Health Services, 00187 Rome, Italy
Gianfranco Damiani: Department of Public Health, Università Cattolica del Sacro Cuore in Rome, 00168 Rome, Italy

IJERPH, 2016, vol. 13, issue 2, 1-12

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.

Keywords: primary health care; health care research; quality of care; inequalities (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2016
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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