The Danish Heart Failure Registry

Schjødt, Inge; Nakano, Anne; Egstrup, Kenneth; Cerqueira, Charlotte

doi:10.2147/clep.s99504

Cited by 25 publications

(48 citation statements)

References 10 publications

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“…In the Danish cohort, hospital departments adhered well to the required annual standard benchmark set by the Danish Heart Failure Database (DHFD) audit commission to maintain one-year mortality at or less than 20% [ 23 ]. We found that the rate of one-year mortality in incident HF patients became even smaller during the three audit years.…”

Section: Discussionmentioning

confidence: 99%

“…We obtained data from the DHFD on 12,001 patients with incident heart failure defined by the following (International Classification of Diseases ICD-10) codes: I 11.0, I 13.0, I 13.2, I 42.0, I 42.6, I 42.7, I 42.9, I 50.0, I 50.1, and I 50.9 [ 1 , 23 ]. The patients were 18 years or older and were newly diagnosed with HF upon hospitalization for the first time (at either an out- or inpatient department) between 21 June 2010 and 30 June 2013 (this period covers three audit years).…”

Section: Population and Methodsmentioning

confidence: 99%

“…In the Swedish cohort, the study outcome is all-cause mortality within one-year after discharge from the hospital. In the Danish cohort, the study outcome is all-cause mortality within one-year after a first contact with a hospital [ 23 ].…”

Section: Population and Methodsmentioning

confidence: 99%

“…In Denmark, there is a special program including the Danish Heart Failure Database “DHFD” along with an audit commission for monitoring and assessing the quality of care for patients with incident heart failure [ 1 ]. Between 2010 and 2013, the oversight body for this audit scheme decided that the standard hospital benchmark for one-year morality rate should be equal to or less than 20% [ 23 ]. Hence, Danish hospital performance was annually audited against this benchmark.…”

Section: Introductionmentioning

confidence: 99%

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The role of the clinical departments for understanding patient heterogeneity in one-year mortality after a diagnosis of heart failure: A multilevel analysis of individual heterogeneity for profiling provider outcomes

2017

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PurposeTo evaluate the general contextual effect (GCE) of the hospital department on one-year mortality in Swedish and Danish patients with heart failure (HF) by applying a multilevel analysis of individual heterogeneity.MethodsUsing the Swedish patient register, we obtained data on 36,943 patients who were 45–80 years old and admitted for HF to the hospital between 2007 and 2009. From the Danish Heart Failure Database (DHFD), we obtained data on 12,001 patients with incident HF who were 18 years or older and treated at hospitals between June 2010 and June2013. For each year, we applied two-step single and multilevel logistic regression models. We evaluated the general effects of the department by quantifying the intra-class correlation coefficient (ICC) and the increment in the area under the receiver operating characteristic curve (AUC) obtained by adding the random effects of the department in a multilevel logistic regression analysis.ResultsOne-year mortality for Danish incident HF patients was low in the three audit years (around 11.1% -13.1%) and departments performed homogeneously (ICC ≈1.5% - 3.5%). The discriminatory accuracy of a model including age and gender was rather high (AUC≈ 0.71–0.73) but the increment in AUC after adding the department random effects into these models was only about 0.011–0.022 units in the three years.One-year mortality in Swedish patients with first hospitalization for heart failure, was relatively higher for 2007–2009 (≈21.3% - 22%) and departments performed homogeneously (ICC ≈ 1.5% - 3%). The discriminatory accuracy of a model including age, gender and patient risk score was rather high (AUC≈ 0.726–0.728) but the increment in AUC after adding the department random effects was only about 0.010–0.017 units in the three years.ConclusionUsing the DHFD standard benchmark for one-year mortality, Danish departments had a good, homogeneous performance. In reference to literature, Swedish departments had a homogeneous performance and the mortality rates for patients with first hospitalization for heart failure were similar to those reported since 2000. Considering this, if health authorities decide to further reduce mortality rates, a comprehensive quality strategy should focus on all Swedish hospitals. Yet, a complementary assessment for the period after the study period is required to confirm whether department performance is still homogeneous or not to determine the most appropriate action.

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Section: Discussionmentioning

confidence: 99%

Section: Population and Methodsmentioning

confidence: 99%

Section: Population and Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The role of the clinical departments for understanding patient heterogeneity in one-year mortality after a diagnosis of heart failure: A multilevel analysis of individual heterogeneity for profiling provider outcomes

2017

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“…New registries and data analysis processes have been developed in diverse fields, in response to PQRS [27‐29]. Quality‐of‐care registries also are taking shape internationally; examples include the National Clinical Audit and Patient Outcomes Programme in the United Kingdom [30], the Burns database in New Zealand [31], and the Danish Heart Failure Registry [32]. New frameworks are being developed for EHR‐based measurement of quality of care; these efforts have to work through unrealistic expectations among stakeholders that quality‐of‐care measurement is easy in EHRs, challenges of the types outlined previously, and new difficulties that arise from the electronic quality‐of‐care data collection and measurement processes themselves [33].…”

Section: Introductionmentioning

confidence: 99%

Data Sharing and Data Registries in Physical Medicine and Rehabilitation

Capó-Lugo

Kho

O’Dwyer

et al. 2017

PM&R

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The field of physical medicine & rehabilitation (PM&R), along with all the disciplines it encompasses, has evolved rapidly in the past 50 years. The number of controlled trials, systematic reviews, and meta-analyses in PM&R increased 5-fold from 1998 to 2013. In recent years, professional, private, and governmental institutions have identified the need to track function and functional status across providers and settings of care and on a larger scale. Because function and functional status are key aspects of PM&R, access to and sharing of reliable data will have an important impact on clinical practice. We reviewed the current landscape of PM&R databases and data repositories, the clinical applicability and practice implications of data sharing, and challenges and future directions. We included articles that (1) addressed any aspect of function, disability, or participation; (2) focused on recovery or maintenance of any function; and (3) used data repositories or research databases. We identified 398 articles that cited 244 data sources. The data sources included 66 data repositories and 179 research databases. We categorized the data sources based on their purposes and uses, geographic distribution, and other characteristics. This study collates the range of databases, data repositories, and data-sharing mechanisms that have been used in PM&R internationally. In recent years, these data sources have provided significant information for the field, especially at the population-health level. Implications and future directions for data sources also are discussed.

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Inequalities in heart failure care in a tax‐financed universal healthcare system: a nationwide population‐based cohort study

et al. 2020

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Aims Data on socioeconomic-related differences in heart failure (HF) care are sparse. Inequality in care may potentially contribute to a poor clinical outcome. We examined socioeconomic-related differences in quality of HF care among patients with incident HF with reduced ejection fraction (EF) (HFrEF). Methods and results We conducted a nationwide population-based cohort study among patients with HFrEF (EF ≤40%) registered from January 2008 to October 2015 in the Danish Heart Failure Registry, a nationwide registry of patients with a first-time primary HF diagnosis. Associations between individual-level socioeconomic factors (cohabitation status, education, and family income) and the quality of HF care defined by six guideline-recommended process performance measures [New York Heart Association (NYHA) classification, treatment with angiotensin-converting-enzyme inhibitors (ACEI)/angiotensin receptor blockers (ARB), beta-blockers and mineralocorticoid receptor antagonists, exercise training, and patient education] were assessed using multiple imputation and multivariable logistic regression controlling for potential confounders. Among 17 122 HFrEF patients included, 15 290 patients had data on all six process performance measures. Living alone was associated with lower odds of NYHA classification [adjusted OR (aOR) 0.81; 95% confidence interval (CI): 0.72-0.90], prescription of ACEI/ARB (aOR 0.76; 95% CI: 0.68-0.88) and beta-blockers (aOR 0.84; 95% CI: 0.76-0.93), referral to exercise training (aOR 0.75; 95% CI: 0.69-0.81), and patient education (aOR 0.73; 95% CI: 0.67-0.80). Compared with high-level education, low-level education was associated with lower odds of NYHA classification (aOR 0.93; 95% CI: 0.79-1.11), treatment with ACEI/ARB (aOR 0.99; 95% CI: 0.81-1.20) and beta-blockers (aOR 0.93; 95% CI: 0.79-1.09), referral to exercise training (aOR 0.73; 95% CI: 0.65-0.82), and patient education (aOR 0.86, 95% CI: 0.75-0.98). An income in the lowest tertile was associated with lower odds of NYHA classification (aOR 0.67; 95% CI: 0.58-0.79), prescription of ACEI/ARB (aOR 0.80, 95% CI: 0.67-0.95) and beta-blockers (aOR 0.88, 95% CI: 0.86-1.01), referral to exercise training (aOR 0.59, 95% CI: 0.53-0.64), and patient education (aOR 0.66; 95% CI: 0.59-0.74) compared with an income in the highest tertile. Overall, no systematic differences were seen when the analyses were stratified by sex and age groups. Conclusions Living alone, low-level education, and income in the lowest tertile were associated with reduced use of recommended processes of HF care among Danish HFrEF patients with a first-time primary HF diagnosis. Efforts are warranted to ensure guideline-recommended HF care to all HFrEF patients, irrespective of socioeconomic background.

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The Danish Heart Failure Registry

Cited by 25 publications

References 10 publications

The role of the clinical departments for understanding patient heterogeneity in one-year mortality after a diagnosis of heart failure: A multilevel analysis of individual heterogeneity for profiling provider outcomes

The role of the clinical departments for understanding patient heterogeneity in one-year mortality after a diagnosis of heart failure: A multilevel analysis of individual heterogeneity for profiling provider outcomes

Data Sharing and Data Registries in Physical Medicine and Rehabilitation

Inequalities in heart failure care in a tax‐financed universal healthcare system: a nationwide population‐based cohort study

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