Which illness puts more elderly people in the hospital than any other? Heart failure, a serious impairment of blood-pumping power.
But, as some Yale researchers have found, the rate of hospitalization for heart failure has gone down a lot, according to Medicare data for the decade ending in 2008.
The analysis is pretty complicated, and makes adjustments for a bunch of risk factors, but the upshot is clear: The rate of heart failure admissions in 2008 was 29.5 percent lower than in 1998. It's the first study to show a national decline.
The change means that about 229,000 admissions, which cost about $18,000 each, were probably avoided in 2008. That's $4.1 billion in savings to Medicare.
What's going on? The researchers figure gains in the treatment of coronary artery disease, better management of blood pressure and more outpatient treatment of the condition are potential explanations.
No matter how you slice it, the trend is a real improvement, says Yale cardiologist Jersey Chen, a co-author of the paper just published in JAMA, the Journal of the American Medical Association, in a video interview.
Heart failure is often fatal in older people. And a separate analysis showed that death within a year of admission for heart failure barely budged, staying around 30 percent.
"While we've made tremendous strides in the decrease in heart failure hospitalizations... it's too early to declare victory," Chen says. "The one-year mortality rate remains very high."
Cardiologist Jersey Chen, lead author of the heart failure study, talks about the findings.