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Medicare News
Senior Citizens Living with Heart Failure Increase
as New Cases Decline
Survival gains result in more Medicare patients
living with heart failure
 Feb. 25, 2008 The number of senior citizens being
diagnosed with heart failure has declined over the last ten years. And,
the number of elderly that are living with this condition has increased,
which is, of course, bad news for Medicare which bears the cost of care.
Catch 22s are not uncommon in the Medicare business
- when it succeeds in helping improve the survival rate from a disease,
it pushes up the program cost because there are more survivors that must
be cared for, even as fewer senior citizens are getting the disease.
This new study finds in happening with heart failure cases.
Heart failure affects nearly 5 million people in
the United States, and more than 300,000 die each year as a result of
the disease. Heart failure is primarily a disease of elderly persons
and, consequently, places a significant and growing economic burden on
the Medicare program, according to a report in the February 25 issue of
Archives of Internal Medicine, one of the JAMA/Archives journals.
The number of people age 65 or older hospitalized
for heart failure from 1984 to 2002 rose by more than 30 percent.
Estimates of the incidence [rate of new cases] and
prevalence [percentage of the population affected] of heart failure in
elderly persons translate directly into projections of resource use for
the Medicare program, so accurate estimates are essential, the authors
of the study point out.
Lesley H. Curtis, Ph.D., of the Duke University
School of Medicine, Durham, N.C., and colleagues analyzed information
obtained from the files of 622,789 Medicare patients age 65 or older who
were diagnosed with heart failure between 1994 and 2003. The rate of new
heart failure occurrences and the number of people living with heart
failure were measured.
The yearly occurrence of heart failure decreased
from 32 per 1,000 person-years (years of observation time during which
each person is at risk to develop the disease) in 1994 to 29 per 1,000
person-years in 2003.
A sharper decline was seen in Medicare patients age
80 to 84 (from 57.5 to 48.4 per 1,000 person-years), while a slight
increase was seen in those age 65 to 69 (from 17.5 to 19.3 per 1,000
person-years).
The number of patients living with the condition
increased steadily from about 140,000 to approximately 200,000 with more
men living with the disease than women each year.
The proportion of beneficiaries with a heart
failure diagnosis grew from 90 per 1,000 in 1994 to 120 per 1,000 in
2000, and remained at about 120 per 1,000 through 2003, the authors
write.
Although the incidence of heart failure has
declined somewhat during the past decade, modest survival gains have
resulted in an increase in the number of patients living with heart
failure, the authors conclude.
Identifying optimal strategies for the treatment
and management of heart failure will become increasingly important as
the size of the Medicare population grows.
Editor's Note: This study was supported in part by
a grant from the National Institute on Aging; a grant from the National
Heart, Lung and Blood Institute; a grant from the Agency for Healthcare
Research and Quality and a research agreement between Medtronic and Duke
University.
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