Rodríguez-Artalejo F, Guallar-Castillón P, Banegas Banegas J R, del Rey Calero J
Departamento de Medicina Preventiva y Salud Pública, Universidad del País Vasco, Vitoria.
Rev Esp Cardiol. 2000 Jun;53(6):776-82. doi: 10.1016/s0300-8932(00)75157-8.
Geographical differences in hospitalizations and mortality for heart failure serve to estimate the potential for reducing the associated hospital and demographic burden on the population. Accordingly, the objective of this paper is to analyze the geographic variation in heart failure hospitalizations and mortality in Spain during the period of 1980-1993, and to examine their potential determinants.
Data on the primary diagnosis of heart failure were taken from the National Hospital Morbidity Survey and National Vital Statistics. Information on determinants of heart failure were obtained from large-scale nationally representative surveys conducted by the National Statistics Office.
The period of 1980-1993 witnessed a decrease in geographical differences in heart failure hospitalizations and mortality. Theoretically, however, heart failure hospitalizations and mortality among persons aged > or = 45 years could still be further reduced by 60% and 30% respectively. In the period of 1989-1993 heart failure hospitalizations were correlated (p < 0.05) with ischaemic heart disease hospitalizations and the number of beds/1,000 inhabitants. Heart failure mortality showed a statistically significant correlation (p < 0.05) with ischaemic heart disease mortality, illiteracy and unemployed status.
There is a great potential for a reduction in the hospital and demographic burden of heart failure in Spain. Control of ischaemic heart disease and a reduction in the geographical differences in socio-economic status would probably contribute to lessening the healthcare burden of heart failure in Spain.
心力衰竭住院率及死亡率的地理差异有助于评估减轻该疾病对人群及医院造成负担的可能性。因此，本文旨在分析1980年至1993年期间西班牙心力衰竭住院率及死亡率的地理差异，并探究其潜在决定因素。
心力衰竭的初次诊断数据取自全国医院发病率调查及全国生命统计数据。心力衰竭决定因素的信息则来自国家统计局开展的具有全国代表性的大规模调查。
1980年至1993年期间，心力衰竭住院率及死亡率的地理差异有所减小。然而，从理论上来说，年龄大于或等于45岁人群的心力衰竭住院率及死亡率仍分别可进一步降低60%和30%。1989年至1993年期间，心力衰竭住院率与缺血性心脏病住院率以及每千名居民的床位数呈正相关（p < 0.05）。心力衰竭死亡率与缺血性心脏病死亡率、文盲率及失业状况呈显著统计学相关性（p < 0.05）。
西班牙在减轻心力衰竭的医院负担及人口负担方面具有巨大潜力。控制缺血性心脏病以及缩小社会经济地位的地理差异可能有助于减轻西班牙心力衰竭的医疗负担。
