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Kolkata-Coventry comparative registry study of acute heart failure: an insight into the impact of public, private and universal health systems on patient outcomes in low–middle income cities (KOLCOV HF Study)
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Banerjee, Suvro, Halder, Swapan Kumar, Kimani, Peter K., Tran, Patrick, Ali, Danish, Roelas, Marina, Weight, Nicholas, Dungarwalla, Moez and Banerjee, Prithwish (2022) Kolkata-Coventry comparative registry study of acute heart failure: an insight into the impact of public, private and universal health systems on patient outcomes in low–middle income cities (KOLCOV HF Study). Open Heart, 9 (1). e001964. doi:10.1136/openhrt-2022-001964
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WRAP-Kolkata-Coventry-comparative-registry-acute-heart-failure-public-patient-income-cities-2022.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons: Attribution-Noncommercial 4.0. Download (999Kb) | Preview |
Official URL: https://doi.org/10.1136/openhrt-2022-001964
Abstract
Introduction: Survival gaps in acute heart failure (AHF) continue to expand globally. Multinational heart failure (HF) registries have highlighted variations between countries. Whether discrepancies in HF practice and outcomes occur across different health systems (ie, private, public or universal healthcare) within a city or between countries remain unclear. Insight into organisational care is also scarce. With increasing public scrutiny of health inequalities, a study to address these limitations is timely. Method: KOLCOV-HF study prospectively compared patients with AHF in public (Nil Ratan Sircar Hospital (NRS)) versus private (Apollo Gleneagles Hospital (AGH)) hospitals of Kolkata, India, and one with universal health coverage in a socioeconomically comparable city of Coventry, England (University Hospitals Coventry & Warwickshire (UHCW)). Data variables were adapted from UK’s National HF Audit programme, collected over 24 months. Predictors of in-hospital mortality and length of hospitalisation were assessed for each centre. Results: Among 1652 patients, in-hospital mortality was highest in government-funded NRS (11.9%) while 3 miles north, AGH had significantly lower mortality (7.5%, p=0.034), similar to UHCW (8%). This could be attributed to distinct HF phenotypes and differences in clinical and organisational care. As expected, low blood pressure was associated with a significantly greater risk of death in patients served by public hospitals UHCW and NRS. Conclusion: Marked differences in HF characteristics, management and outcomes exist intra-regionally, and between low–middle versus high-income countries across private, public and universal healthcare systems. Physicians and policymakers should take caution when applying country-level data locally when developing strategies to address local evidence-practice gaps in HF.
| Item Type: | Journal Article | ||||||
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| Subjects: | R Medicine > RC Internal medicine | ||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Statistics and Epidemiology Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| SWORD Depositor: | Library Publications Router | ||||||
| Library of Congress Subject Headings (LCSH): | Heart failure -- Treatment, Heart failure, Medical policy -- Research | ||||||
| Journal or Publication Title: | Open Heart | ||||||
| Publisher: | BMJ Publishing Group | ||||||
| ISSN: | 2053-3624 | ||||||
| Official Date: | 31 May 2022 | ||||||
| Dates: |
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| Volume: | 9 | ||||||
| Number: | 1 | ||||||
| Article Number: | e001964 | ||||||
| DOI: | 10.1136/openhrt-2022-001964 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Reuse Statement (publisher, data, author rights): | ** Embargo end date: 31-05-2022 ** From BMJ via Jisc Publications Router ** History: received 06-01-2022; accepted 11-04-2022; ppub 05-2022; epub 31-05-2022. ** Licence for this article starting on 31-05-2022: http://creativecommons.org/licenses/by-nc/4.0/ | ||||||
| Access rights to Published version: | Open Access | ||||||
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