Regional inequalities in heart failure hospitalisation and in-hospital mortality in Spain (2016-2022)

Heart failure remains one of the leading causes of hospital admissions and mortality worldwide, with substantial regional disparities in clinical outcomes. These variations have been linked to differences in socioeconomic conditions, health determinants, and health-care system organisation. The aim...

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Autores: Ortiz-Cortés, Carolina, Fernández-Friera, Leticia, Gámez, José M., Cequier, Ángel|||0000-0002-3230-0011, Bonanad Lozano, Clara, Sambola, Antonia, Facila Rubio, Lorenzo|||0000-0003-1402-4364, Rodríguez-Padial, Luis|||0000-0002-5783-3922, Campuzano Ruíz, Raquel, Pedreira Pérez, Milagros, de la Torre Hernández, José M., Rosillo, Nicolás, Sánchez Fernández, Sofía, del Prado, Náyade, Bernal, José Luis, Fernández Pérez, Cristina, Alvaredo, Diego, Rico-Martín, Sergio, Elola-Somoza, Francisco Javier
Tipo de recurso: artículo
Fecha de publicación:2025
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:dnet:uabarcelona_::c7e450ee50887c8261eed03eed2d3f26
Acceso en línea:https://ddd.uab.cat/record/326465
https://dx.doi.org/urn:doi:10.1016/j.lanepe.2025.101549
Access Level:acceso abierto
Palabra clave:Heart failure
Hospitalisation
In-hospital mortality
Regional disparities
Socioeconomic factors
Health determinants
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spelling Regional inequalities in heart failure hospitalisation and in-hospital mortality in Spain (2016-2022)a nationwide, observational studyOrtiz-Cortés, CarolinaFernández-Friera, LeticiaGámez, José M.Cequier, Ángel|||0000-0002-3230-0011Bonanad Lozano, ClaraSambola, AntoniaFacila Rubio, Lorenzo|||0000-0003-1402-4364Rodríguez-Padial, Luis|||0000-0002-5783-3922Campuzano Ruíz, RaquelPedreira Pérez, Milagrosde la Torre Hernández, José M.Rosillo, NicolásSánchez Fernández, Sofíadel Prado, NáyadeBernal, José LuisFernández Pérez, CristinaAlvaredo, DiegoRico-Martín, SergioElola-Somoza, Francisco JavierHeart failureHospitalisationIn-hospital mortalityRegional disparitiesSocioeconomic factorsHealth determinantsHeart failure remains one of the leading causes of hospital admissions and mortality worldwide, with substantial regional disparities in clinical outcomes. These variations have been linked to differences in socioeconomic conditions, health determinants, and health-care system organisation. The aim of this study was to analyse regional differences in hospitalisation rates and in-hospital mortality for heart failure across Spain's autonomous communities, and to examine their associations with hospital characteristics and regional health determinants. We conducted a nationwide, retrospective, population-based study using Spain's national hospital discharge database (Conjunto Mínimo Básico de Datos, CMBD) to identify adults (≥18 years) discharged from public general hospitals within the Spanish National Health System (SNS) with a primary diagnosis of heart failure from January 1, 2016, to December 31, 2022. Differences in hospitalisation rates and risk-standardised in-hospital mortality between autonomous communities were analysed, along with associations with hospital characteristics and regional health determinants. A total of 764,083 hospitalisations for heart failure were analysed. The mean age of participants was 80.8 ± 10.6 years. The age- and sex-standardised hospitalisation rate was 255 per 100,000 inhabitants, with significant differences between autonomous communities. Crude in-hospital mortality rate was 11.3% (86,426 episodes), with substantial regional variation in risk-standardised mortality rate (ranged from 7.7% to 16.4%) No associations were found between hospital characteristics and risk-standardised mortality rate at the regional level. Regional health determinants were highly collinear; among all determinants assessed, per-capita gross domestic product was independently associated with lower risk-standardised mortality (βGDP = -0.77; 95% CI: -1.04 to -0.49; p.Universitat Autònoma de Barcelona. Departament de Medicina 22025-01-0120252025-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/326465https://dx.doi.org/urn:doi:10.1016/j.lanepe.2025.101549reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:dnet:uabarcelona_::c7e450ee50887c8261eed03eed2d3f262026-06-06T12:50:31Z
dc.title.none.fl_str_mv Regional inequalities in heart failure hospitalisation and in-hospital mortality in Spain (2016-2022)
a nationwide, observational study
title Regional inequalities in heart failure hospitalisation and in-hospital mortality in Spain (2016-2022)
spellingShingle Regional inequalities in heart failure hospitalisation and in-hospital mortality in Spain (2016-2022)
Ortiz-Cortés, Carolina
Heart failure
Hospitalisation
In-hospital mortality
Regional disparities
Socioeconomic factors
Health determinants
title_short Regional inequalities in heart failure hospitalisation and in-hospital mortality in Spain (2016-2022)
title_full Regional inequalities in heart failure hospitalisation and in-hospital mortality in Spain (2016-2022)
title_fullStr Regional inequalities in heart failure hospitalisation and in-hospital mortality in Spain (2016-2022)
title_full_unstemmed Regional inequalities in heart failure hospitalisation and in-hospital mortality in Spain (2016-2022)
title_sort Regional inequalities in heart failure hospitalisation and in-hospital mortality in Spain (2016-2022)
dc.creator.none.fl_str_mv Ortiz-Cortés, Carolina
Fernández-Friera, Leticia
Gámez, José M.
Cequier, Ángel|||0000-0002-3230-0011
Bonanad Lozano, Clara
Sambola, Antonia
Facila Rubio, Lorenzo|||0000-0003-1402-4364
Rodríguez-Padial, Luis|||0000-0002-5783-3922
Campuzano Ruíz, Raquel
Pedreira Pérez, Milagros
de la Torre Hernández, José M.
Rosillo, Nicolás
Sánchez Fernández, Sofía
del Prado, Náyade
Bernal, José Luis
Fernández Pérez, Cristina
Alvaredo, Diego
Rico-Martín, Sergio
Elola-Somoza, Francisco Javier
author Ortiz-Cortés, Carolina
author_facet Ortiz-Cortés, Carolina
Fernández-Friera, Leticia
Gámez, José M.
Cequier, Ángel|||0000-0002-3230-0011
Bonanad Lozano, Clara
Sambola, Antonia
Facila Rubio, Lorenzo|||0000-0003-1402-4364
Rodríguez-Padial, Luis|||0000-0002-5783-3922
Campuzano Ruíz, Raquel
Pedreira Pérez, Milagros
de la Torre Hernández, José M.
Rosillo, Nicolás
Sánchez Fernández, Sofía
del Prado, Náyade
Bernal, José Luis
Fernández Pérez, Cristina
Alvaredo, Diego
Rico-Martín, Sergio
Elola-Somoza, Francisco Javier
author_role author
author2 Fernández-Friera, Leticia
Gámez, José M.
Cequier, Ángel|||0000-0002-3230-0011
Bonanad Lozano, Clara
Sambola, Antonia
Facila Rubio, Lorenzo|||0000-0003-1402-4364
Rodríguez-Padial, Luis|||0000-0002-5783-3922
Campuzano Ruíz, Raquel
Pedreira Pérez, Milagros
de la Torre Hernández, José M.
Rosillo, Nicolás
Sánchez Fernández, Sofía
del Prado, Náyade
Bernal, José Luis
Fernández Pérez, Cristina
Alvaredo, Diego
Rico-Martín, Sergio
Elola-Somoza, Francisco Javier
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona. Departament de Medicina
dc.subject.none.fl_str_mv Heart failure
Hospitalisation
In-hospital mortality
Regional disparities
Socioeconomic factors
Health determinants
topic Heart failure
Hospitalisation
In-hospital mortality
Regional disparities
Socioeconomic factors
Health determinants
description Heart failure remains one of the leading causes of hospital admissions and mortality worldwide, with substantial regional disparities in clinical outcomes. These variations have been linked to differences in socioeconomic conditions, health determinants, and health-care system organisation. The aim of this study was to analyse regional differences in hospitalisation rates and in-hospital mortality for heart failure across Spain's autonomous communities, and to examine their associations with hospital characteristics and regional health determinants. We conducted a nationwide, retrospective, population-based study using Spain's national hospital discharge database (Conjunto Mínimo Básico de Datos, CMBD) to identify adults (≥18 years) discharged from public general hospitals within the Spanish National Health System (SNS) with a primary diagnosis of heart failure from January 1, 2016, to December 31, 2022. Differences in hospitalisation rates and risk-standardised in-hospital mortality between autonomous communities were analysed, along with associations with hospital characteristics and regional health determinants. A total of 764,083 hospitalisations for heart failure were analysed. The mean age of participants was 80.8 ± 10.6 years. The age- and sex-standardised hospitalisation rate was 255 per 100,000 inhabitants, with significant differences between autonomous communities. Crude in-hospital mortality rate was 11.3% (86,426 episodes), with substantial regional variation in risk-standardised mortality rate (ranged from 7.7% to 16.4%) No associations were found between hospital characteristics and risk-standardised mortality rate at the regional level. Regional health determinants were highly collinear; among all determinants assessed, per-capita gross domestic product was independently associated with lower risk-standardised mortality (βGDP = -0.77; 95% CI: -1.04 to -0.49; p.
publishDate 2025
dc.date.none.fl_str_mv 2
2025-01-01
2025
2025-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/326465
https://dx.doi.org/urn:doi:10.1016/j.lanepe.2025.101549
url https://ddd.uab.cat/record/326465
https://dx.doi.org/urn:doi:10.1016/j.lanepe.2025.101549
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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