Chronic heart failure (CHF) combines a high prevalence with disabling symptoms and high hospitalization rates. These place a heavy burden on not only patients and their families but also on society, through enormous use of health care resources. CHF has an overall population prevalence of about 1-3%, rising to about 10% in the very elderly. Following a first hospital admission for heart failure, patients have a 5 year mortality of 75% - a survival rate worse than that for most forms of cancer. CHF impairs quality of life more than almost any other chronic medical problem. Patients with severe CHF are willing to trade a high proportion of their remaining life for symptom relief. Hospital admissions for CHF have increased markedly over the past two decades, and hospitalization is the major contributor to medical costs. In most countries CHF accounts for about 5% of all medical admissions and approximately 2% of total health care expenditure. Despite improvements in medical management, under-treatment is common. Because of the increase in survival after acute myocardial infarction and ageing of the population, the number of patients with CHF is set to increase rapidly in most Western industrialized countries. Numbers of hospitalizations will also rise sharply, particularly among elderly patients. Thus, although important advances have been made in the management of heart failure, it will still pose one of the greatest health care challenges of the 21st century.
- Health economics
- Heart failure