Decade of reduced hospitalizations and improved outcomes for cardiovascular disease and stroke patients

Cardiovascular disease and stroke are the first and fourth leading causes of death in the United States, and U.S. mortality from circulatory system diseases is relatively high compared to similarly wealthy OECD countries. Yet, a recent study reveals that hospitalizations and mortality rates for both have declined considerably over the past decade. Between 1999 and 2011, hospitalization rates dropped 38 percent for heart attacks, 31 percent for heart failure, 34 percent for ischemic stroke, and 84 percent for unstable angina – the chest pain and discomfort often caused by narrowing of the coronary artery carrying blood to the heart.

The study  examined changes in cardiovascular and stroke disease hospitalization rates, readmissions, mortality, and other outcomes for a national cohort of Medicare Fee-For-Service beneficiaries aged 65 and up. By 2011, deaths and hospital readmission rates had also dropped for patients suffering a heart attack, unstable angina, heart failure, and ischemic stroke.

“This improvement in rates of hospitalization is far greater than that achieved for other causes of hospitalization. Importantly, the declines and improvements in cardiovascular conditions and stroke were not associated with increases in hospitalizations for other conditions, and the improvements occurred across demographic groups.”

Krumholz and colleagues, Circulation

Among other factors, the study highlights quality improvement and public reporting efforts as likely drivers of the improvements. Hospitalizations dropped despite fluctuations over time in the diagnoses of unstable angina and heart attack, suggesting that diagnostic and coding inconsistencies were not mitigating outcomes.