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US patients with heart failure have better short-term survival rates than Canadian patients

CHICAGO Elderly patients with heart failure who are hospitalized in the United States have lower death rates at 30 days than patients hospitalized in Canada for the same illness, but one-year death rates are similar in the U.S. and Canada, according to a study in the November 28 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

The United States and Canada have different methods of financing and providing health care. The U.S. market-oriented system with limited governmental control is in sharp contrast to Canada's single-payer system, which covers most physician and hospital services and prescription medications. Canadian budgetary restraints have resulted in limited access to specialized care, such as invasive cardiac procedures and physician specialists, according to background information in the article. Health care expenditure per person is significantly higher in the U.S. compared with Canada, but whether there are differences in quality of care of many conditions is unknown.

Dennis T. Ko, M.D., of the University of Toronto, Ontario, and colleagues compared processes of care and 30-day and one-year risk-standardized mortality rates among 28,521 U.S. Medicare beneficiaries and 8,180 similarly aged patients in Ontario, Canada, who were hospitalized with heart failure from 1998 to 2001. Heart failure--a condition in which the ventricles, or lower chambers of the heart, are not able to pump blood effectively--is the most common cause of hospitalization for individuals aged 65 and older in both countries.

"More U.S. patients underwent left ventricular ejection fraction assessment [a test to evaluate the pumping action of the lower chambers of the heart] during hospitalization compared with Canadian patients (61.2 percent vs. 41.7 percent)," the authors write.

The authors also looked at the use of medications commonly prescribed for heart patients. "At discharge, patients in the United States were pres
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Contact: Karen Peart
203-432-1326
JAMA and Archives Journals
28-Nov-2005


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