Potentially avoidable hospitalizations for heart failure in Switzerland

Abstract Background Timely and appropriate outpatient care can prevent potentially avoidable hospitalizations (PAH) for heart failure. We analysed the trends, determinants, and consequences of PAH for heart failure in Switzerland over two decades. Methods Hospital discharge data from Switzerland for the years 1998 to 2018. PAH was defined according to the Organization for Economic Cooperation and Development criteria (OECD). Results The number of PAH for heart failure increased from 2,633 in 1998 to 111,338 in 2018. However, expressed as percentage of total admissions for heart failure, there was a slight decrease in the prevalence of such admissions, declining from approximately 80% in 1998 to 78% in 2018. Compared to non-PAH, PAH for heart failure were more frequently in the middle age to older age categories, non-Swiss, without health insurance, with lower comorbidities as per Charlson’s index, and more frequently observed in the Zurich, Eastern, Central and Tessin regions of Switzerland (table). PAH for heart failure were more frequently admitted as an emergency, via the patient’s (table). Conversely, patients with PAH for heart failure stayed less frequently in the ICU (14.1% vs. 8.9%, p0.001) and were mostly discharged home (25.57% vs. 70.0%, p0.001) than patients without PAH. The length of stay was longer in PAH than non-PAH cases (9.4±1.0 vs. 8.7±1.0 days, p=0.001), but their cost was lower (11,404 vs. 12,954 CHF, p0.001). In 2018, the overall financial burden associated with PAH for heart failure was estimated at 120.5 million CHF. Conclusion In Switzerland, the number of PAH for heart failure has increased considerably. The medical and financial burden due to the PAH for heart failure could be reduced with timely and appropriate outpatient care.