National and Regional Trends in Heart Failure Hospitalization and Mortality Rates for Medicare Beneficiaries, 1998-2008

ContextIt is not known whether recent declines in ischemic heart disease and its risk factors have been accompanied by declines in heart failure (HF) hospitalization and mortality.ObjectiveTo examine changes in HF hospitalization rate and 1-year mortality rate in the United States, nationally and by state or territory.Design, Setting, and ParticipantsFrom acute care hospitals in the United States and Puerto Rico, 55 097 390 fee-for-service Medicare beneficiaries hospitalized between 1998 and 2008 with a principal discharge diagnosis code for HF.Main Outcome MeasuresChanges in patient demographics and comorbidities, HF hospitalization rates, and 1-year mortality rates.ResultsThe HF hospitalization rate adjusted for age, sex, and race declined from 2845 per 100 000 person-years in 1998 to 2007 per 100 000 person-years in 2008 (P ConclusionsThe overall HF hospitalization rate declined substantially from 1998 to 2008 but at a lower rate for black men. The overall 1-year mortality rate declined slightly over the past decade but remains high. Changes in HF hospitalization and 1-year mortality rates were uneven across states.