Delivering quality and value in heart failure

doi:10.1136/bmj.b1672

Published 30 April 2009, doi:10.1136/bmj.b1672
Cite this as: BMJ 2009;338:b1672

Editorials

Delivering quality and value in heart failure

New guidance fails to communicate exactly what is needed andhow much it will cost

The first 150 words of the full text of this article appear below.

The NHS Institute for Innovation and Improvement recently publishedthe first in a series of guidance documents Focus on heart failure.¹The series is aimed principally at healthcare managers, commissioners,and general practitioners.

Heart failure and left ventricular systolic dysfunction areassociated with a poor prognosis, worse quality of life thanmost other chronic disorders,² and high admission and readmissionrates (nearly a quarter of patients are readmitted within 12weeks of discharge).³ Heart failure accounts for at least 2%of total healthcare expenditure⁴— ${euro}$ 26m (£23m; $34m)per million population in the United Kingdom and ${euro}$ 70m per millionpopulation in the United States. Annual mortality in severeheart failure is around 60%,⁵ with a five year mortality inthe general population of around 42%.⁶

So heart failure is important, but what is the aim of the publicationand does it succeed? The stated purpose is to "help local . . . [Full text of this article]

F D Richard Hobbs, professor and head of department

¹ Primary care Clinical Sciences, University of Birmingham, Birmingham B15 2TT

f.d.r.hobbs@bham.ac.uk