Decline in Medicare Patients’ Heart Hospitalizations Sends Hearts Racing

Medicare patients saw a 38 percent decrease in heart attack hospitalizations between 1999 and 2011. The amount of Medicare patients hospitalized with blood-clot-related strokes fell 34 percent, and angina-related hospitalizations decreased by an astounding 84 percent. Additionally, the risk of dying within a year of being hospitalized decreased by 13 percent for patients suffering from heart failure and stroke and by 23 percent for those who suffered heart attacks.

Though doctors are not able to pinpoint an exact cause for the encouraging decreases, the steady decline is likely attributed to people smoking less, the diabetes epidemic’s affect on afflicted peoples’ diets and exercise habits, and the fact that more elderly adults are taking cholesterol-lowering medications.

Perhaps, the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148) may have helped in attaining these successes.

Section 10411 of the ACA was designated the Congenital Heart Futures Act (Act), enacted March 2010. Through this Act, HHS established a National Congenital Heart Disease Surveillance System through the Centers for Disease Control and Prevention (CDC), which facilitates research into the types of health services used by patients and to identify possible areas for educational outreach and prevention. The collected data will be stored in a national, population-based database that can be used by researchers and the public to monitor the epidemiology of congenital heart disease.

The Congenital Heart Disease Surveillance System is designed to:

  • collect data regarding congenital heart disease’s prevalence in the United States;
  • collect and store congenital heart disease data regarding risk factors, population demographic factors, causes, treatments, and outcome measures that would provide best practices and guidelines for patients; and
  • ensure the collection and analysis of longitudinal data related to all individuals who have congenital heart disease.

Under the ACA, the director of the National Heart, Lung, and Blood Institute is also authorized to expand congenital heart disease research and any related activities.

Dr. Harlan M. Krumholz, director of the Yale-New Haven Hospital Center for Outcomes Research and Evaluation in Connecticut, is encouraged and says that with an increased focus on heart disease, doctors’ ability to identify and treat high blood pressure and secure fast, appropriate treatment to heart attack sufferers improved between 1999 and 2011. Krumholz also attributes the decline in hospitalizations to the fact that “[a] lot of people and organizations have been working really hard for the past 10 to 15 years to make better use of the knowledge we have.” It is possible that the ACA surveillance system contributed to this knowledge.

Not all the news is positive. The director of women’s heart health at the Heart and Vascular Institute at New York’s Lenox Hill Hospital, Suzanne Steinbaum, worries that the positive trends will reverse if obesity and diabetes in young Americans, who are ineligible for Medicare, continue to grow. She notes that heart attack rates are increasing in younger women, especially African Americans, and the CDC notes that there are 800,000 heart-related deaths each year.

Howard Herrmann, director of Interventional Cardiology and Cardiac Catheterization at the Hospital of the University of Pennsylvania, stresses continued vigilance in heart disease awareness and prevention as a key factor to keeping the rates of heart disease and death on a downward trend.

With the ACA surveillance system as a potential backdrop for proactive physician and patient approaches to heart health, how many more lives and health care expenses can be saved?