Self-rated health predicts healthcare utilization in heart failure

Alanna Chamberlain, Sheila M. Manemann, Shannon M Dunlay, John A. Spertus, Debra K. Moser, Cecilia Berardi, Robert L. Kane, Susan A. Weston, Margaret May Redfield, Veronique Lee Roger

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: Heart failure (HF) patients experience impaired functional status, diminished quality of life, high utilization of healthcare resources, and poor survival. Yet, the identification of patient-centered factors that influence prognosis is lacking. Methods and Results: We determined the association of 2 measures of self-rated health with healthcare utilization and skilled nursing facility (SNF) admission in a community cohort of 417 HF patients prospectively enrolled between October 2007 and December 2010 from Olmsted County, MN. Patients completed a 12-item Short Form Health Survey (SF-12). Low self-reported physical functioning was defined as a score ≤ 25 on the SF-12 physical component. The first question of the SF-12 was used as a measure of self-rated general health. After 2 years, 1033 hospitalizations, 1407 emergency department (ED) visits, and 19,780 outpatient office visits were observed; 87 patients were admitted to a SNF. After adjustment for confounding factors, an increased risk of hospitalizations (1.52 [1.17 to 1.99]) and ED visits (1.48 [1.04 to 2.11]) was observed for those with low versus moderatehigh self-reported physical functioning. Patients with poor and fair self-rated general health also experienced an increased risk of hospitalizations (poor: 1.73 [1.29 to 2.32]; fair: 1.46 [1.14 to 1.87]) and ED visits (poor: 1.73 [1.16 to 2.56]; fair: 1.48 [1.13 to 1.93]) compared with good-excellent self-rated general health. No association between self-reported physical functioning or selfrated general health with outpatient visits and SNF admission was observed. Conclusion: In community HF patients, self-reported measures of physical functioning predict hospitalizations and ED visits, indicating that these patient-reported measures may be useful in risk stratification and management in HF.

Original languageEnglish (US)
Article number000931
JournalJournal of the American Heart Association
Volume3
Issue number3
DOIs
StatePublished - 2014

Fingerprint

Heart Failure
Delivery of Health Care
Health
Skilled Nursing Facilities
Hospital Emergency Service
Hospitalization
Outpatients
Office Visits
Risk Management
Health Surveys
Quality of Life
Survival

Keywords

  • Healthcare utilization
  • Heart failure
  • Hospitalizations
  • Physical functioning
  • Self-rated health

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Self-rated health predicts healthcare utilization in heart failure. / Chamberlain, Alanna; Manemann, Sheila M.; Dunlay, Shannon M; Spertus, John A.; Moser, Debra K.; Berardi, Cecilia; Kane, Robert L.; Weston, Susan A.; Redfield, Margaret May; Roger, Veronique Lee.

In: Journal of the American Heart Association, Vol. 3, No. 3, 000931, 2014.

Research output: Contribution to journalArticle

Chamberlain, Alanna ; Manemann, Sheila M. ; Dunlay, Shannon M ; Spertus, John A. ; Moser, Debra K. ; Berardi, Cecilia ; Kane, Robert L. ; Weston, Susan A. ; Redfield, Margaret May ; Roger, Veronique Lee. / Self-rated health predicts healthcare utilization in heart failure. In: Journal of the American Heart Association. 2014 ; Vol. 3, No. 3.
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abstract = "Background: Heart failure (HF) patients experience impaired functional status, diminished quality of life, high utilization of healthcare resources, and poor survival. Yet, the identification of patient-centered factors that influence prognosis is lacking. Methods and Results: We determined the association of 2 measures of self-rated health with healthcare utilization and skilled nursing facility (SNF) admission in a community cohort of 417 HF patients prospectively enrolled between October 2007 and December 2010 from Olmsted County, MN. Patients completed a 12-item Short Form Health Survey (SF-12). Low self-reported physical functioning was defined as a score ≤ 25 on the SF-12 physical component. The first question of the SF-12 was used as a measure of self-rated general health. After 2 years, 1033 hospitalizations, 1407 emergency department (ED) visits, and 19,780 outpatient office visits were observed; 87 patients were admitted to a SNF. After adjustment for confounding factors, an increased risk of hospitalizations (1.52 [1.17 to 1.99]) and ED visits (1.48 [1.04 to 2.11]) was observed for those with low versus moderatehigh self-reported physical functioning. Patients with poor and fair self-rated general health also experienced an increased risk of hospitalizations (poor: 1.73 [1.29 to 2.32]; fair: 1.46 [1.14 to 1.87]) and ED visits (poor: 1.73 [1.16 to 2.56]; fair: 1.48 [1.13 to 1.93]) compared with good-excellent self-rated general health. No association between self-reported physical functioning or selfrated general health with outpatient visits and SNF admission was observed. Conclusion: In community HF patients, self-reported measures of physical functioning predict hospitalizations and ED visits, indicating that these patient-reported measures may be useful in risk stratification and management in HF.",
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AU - Chamberlain, Alanna

AU - Manemann, Sheila M.

AU - Dunlay, Shannon M

AU - Spertus, John A.

AU - Moser, Debra K.

AU - Berardi, Cecilia

AU - Kane, Robert L.

AU - Weston, Susan A.

AU - Redfield, Margaret May

AU - Roger, Veronique Lee

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N2 - Background: Heart failure (HF) patients experience impaired functional status, diminished quality of life, high utilization of healthcare resources, and poor survival. Yet, the identification of patient-centered factors that influence prognosis is lacking. Methods and Results: We determined the association of 2 measures of self-rated health with healthcare utilization and skilled nursing facility (SNF) admission in a community cohort of 417 HF patients prospectively enrolled between October 2007 and December 2010 from Olmsted County, MN. Patients completed a 12-item Short Form Health Survey (SF-12). Low self-reported physical functioning was defined as a score ≤ 25 on the SF-12 physical component. The first question of the SF-12 was used as a measure of self-rated general health. After 2 years, 1033 hospitalizations, 1407 emergency department (ED) visits, and 19,780 outpatient office visits were observed; 87 patients were admitted to a SNF. After adjustment for confounding factors, an increased risk of hospitalizations (1.52 [1.17 to 1.99]) and ED visits (1.48 [1.04 to 2.11]) was observed for those with low versus moderatehigh self-reported physical functioning. Patients with poor and fair self-rated general health also experienced an increased risk of hospitalizations (poor: 1.73 [1.29 to 2.32]; fair: 1.46 [1.14 to 1.87]) and ED visits (poor: 1.73 [1.16 to 2.56]; fair: 1.48 [1.13 to 1.93]) compared with good-excellent self-rated general health. No association between self-reported physical functioning or selfrated general health with outpatient visits and SNF admission was observed. Conclusion: In community HF patients, self-reported measures of physical functioning predict hospitalizations and ED visits, indicating that these patient-reported measures may be useful in risk stratification and management in HF.

AB - Background: Heart failure (HF) patients experience impaired functional status, diminished quality of life, high utilization of healthcare resources, and poor survival. Yet, the identification of patient-centered factors that influence prognosis is lacking. Methods and Results: We determined the association of 2 measures of self-rated health with healthcare utilization and skilled nursing facility (SNF) admission in a community cohort of 417 HF patients prospectively enrolled between October 2007 and December 2010 from Olmsted County, MN. Patients completed a 12-item Short Form Health Survey (SF-12). Low self-reported physical functioning was defined as a score ≤ 25 on the SF-12 physical component. The first question of the SF-12 was used as a measure of self-rated general health. After 2 years, 1033 hospitalizations, 1407 emergency department (ED) visits, and 19,780 outpatient office visits were observed; 87 patients were admitted to a SNF. After adjustment for confounding factors, an increased risk of hospitalizations (1.52 [1.17 to 1.99]) and ED visits (1.48 [1.04 to 2.11]) was observed for those with low versus moderatehigh self-reported physical functioning. Patients with poor and fair self-rated general health also experienced an increased risk of hospitalizations (poor: 1.73 [1.29 to 2.32]; fair: 1.46 [1.14 to 1.87]) and ED visits (poor: 1.73 [1.16 to 2.56]; fair: 1.48 [1.13 to 1.93]) compared with good-excellent self-rated general health. No association between self-reported physical functioning or selfrated general health with outpatient visits and SNF admission was observed. Conclusion: In community HF patients, self-reported measures of physical functioning predict hospitalizations and ED visits, indicating that these patient-reported measures may be useful in risk stratification and management in HF.

KW - Healthcare utilization

KW - Heart failure

KW - Hospitalizations

KW - Physical functioning

KW - Self-rated health

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