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The European Journal of Public Health 2004 14(2):123-127; doi:10.1093/eurpub/14.2.123
© 2004 by European Journal of Public Health
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Chronic diseases

Age and quality of in-hospital care of patients with heart failure

Michel P. Kossovsky1,2,3, François P. Sarasin1,3, Martine Louis-Simonet1,3, Pierre Chopard1,2,3, Philippe Sigaud1,3, Thomas V. Perneger2,3,4 and Jean-Michel Gaspoz1,3

1 Department of Internal Medicine, Geneva University Hospitals 2 Quality of Care Unit, Geneva University Hospitals 3 Groupe de Recherche et d'Analyse en Systèmes et Soins Hospitaliers (GRASSH), Geneva University Hospitals 4 Institute of Social and Preventive Medicine, University of Geneva, Switzerland

Background: Elderly patients may be at risk of suboptimal care. Thus, the relationship between age and quality of care for patients hospitalized for heart failure was examined. Methods: A cross-sectional study based on retrospective chart review was performed among a random sample of patients hospitalized between 1996 and 1998 in the general internal medicine wards, with a principal diagnosis of congestive heart failure, and discharged alive. Explicit criteria of quality of care, grouped into three scores, were used: admission work-up (admission score); evaluation and treatment during the stay (evaluation and treatment score); and readiness for discharge (discharge score). The associations between age and quality of care scores were analysed using linear regression models. Results: Charts of 371 patients were reviewed. Mean age was 75.7 (±11.1) years and 52% were men. There was no relationship between age and admission or readiness for discharge scores. The evaluation and treatment score decreased with age: compared with patients less than 70 years old, the score was lower by –2.6% (95% CI: –7.1 to 1.9) for patients aged 70 to 79, by –8.7% (95% CI: –13.0 to –4.3) for patients aged 80 to 89, and by –19.0% (95% CI: –26.6 to –11.5) for patients aged 90 and over. After adjustment for possible confounders, this relationship was not significantly modified. Conclusions: In patients hospitalized for congestive heart failure, older age was not associated with lower quality of care scores except for evaluation and treatment. Whether this is detrimental to elderly patients remains to be evaluated.

Keywords: age, congestive heart failure, quality of care

Received 11 March 2002. Accepted 3 February 2003.

* Correspondence: Dr M. Kossovsky, Département de Médecine interne, Hôpitaux Universitaires de Genève, 1211 Geneva 14, Switzerland, tel. +41 22 372 9014, fax +41 22 372 9016, e-mail: michel.picard-kossovsky{at}hcuge.ch


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