Heart failure: the commonest reason for hospital admission in Germany: medical and economic perspectives

Abstract

Background: Heart failure is now the commonest reason for hospitalization in Germany (German Federal Statistical Office, 2008). Heart failure will continue to be a central public health issue in the future as the population ages. This article focuses on regional differences, the costs of the disease, and the expected rate of increase in cases in the near future.

Methods: This analysis is based on diagnosis statistics, cause-of-death statistics, and cost of illness data, as reported by the German Federal Statistical Office. Age- and sex-specific differences are taken into account.

Results: 2006 was the first year in which heart failure led to more hospital admissions in Germany (317 000) than any other diagnosis. At present, about 141 000 persons in Germany aged 80 and over have heart failure; by the year 2050, it is predicted that more than 350 000 persons in this age group will be affected. The rate of diagnosis of heart failure, its frequency as a cause of death, and the costs associated with it all vary across the individual states of the Federal Republic of Germany. The nationwide cost of heart failure in 2006 was estimated at 2.9 billion euros.

Conclusions: These findings reveal that heart failure has become more common as an admission diagnosis of hospitalized patients in Germany. Because the population is aging, new concepts for prevention and treatment will be needed in the near future so that the affected patients can continue to receive adequate care.

Keywords: health services research; heart failure; hospitalization; population trends; regional differences.

Figure 1

Heart failure as primary diagnosis in German hospitals, 2000–2006 (age-adjusted number of cases per 100 000 head of population)

Figure 2

Heart failure as primary diagnosis in German hospitals, 2006 (age-adjusted number of cases per 100 000 head of population): whole of Germany and individual German states

Figure 3

Mortality from heart failure, 2007 (age-adjusted deaths per 100 000 population)