The province of Alberta, Canada avoids the hospitalization epidemic for congestive heart failure patients

Background: We assessed the incidence and prevalence of congestive heart failure (CHF) in patients diagnosed at the time of hospitalization and patients diagnosed in specialists offices without prior hospitalization in order to compare the trends in Canada with previously published trends in the USA and other industrialized countries. Methods: Administrative data for Alberta, Canada from 1 April 1994 to 31 March 2000. Results: There was a small but statistically significant decline in the age–sex incident and prevalent hospitalization rates for CHF between 1994/1995 (incidence per 1000 of 1.59; 99% CI 1.51, 1.66: prevalence per 1000 of 2.31; 99% CI 2.22, 2.40) and the year 1999/2000 (incidence per 1000 of 1.24; 99% CI 1.18, 1.30: prevalence per 1000 of 1.97; 99% CI 1.89, 2.05). Crude hospitalization rate per 1000 also demonstrated a small but statistically significant decline between 1994/1995 (2.98; 99% CI 2.88, 3.08) and 1999/2000 (2.55; 99% CI 2.46, 2.64). The age–sex incident rates of ambulatory diagnosis of CHF were similar throughout the 1994/1995 to1999/2000 time period (0.88; 99% CI 0.82, 0.94 during 1994/1995 and 0.84; 99% CI 0.79, 0.89 during 1999/2000). The crude mortality percentage for incident hospitalization for CHF were similar throughout the 1994/1995 to1999/2000 time period (31.0%; 99% CI 28.7, 33.3 during 1994/1995 and 28.6%; 99% CI 26.3, 30.9 during 1999/2000). Conclusions: We noted a small decrease in the incident, prevalent, and total hospitalizations for CHF in the time period 1994/1995–1999/2000. The decrease was not the result of a substituted increase in ambulatory diagnosis for CHF.