Editorials

Delivering quality and value in heart failure

BMJ 2009; 338 doi: https://doi.org/10.1136/bmj.b1672 (Published 30 April 2009) Cite this as: BMJ 2009;338:b1672
  1. F D Richard Hobbs, professor and head of department
  1. 1Primary care Clinical Sciences, University of Birmingham, Birmingham B15 2TT
  1. f.d.r.hobbs{at}bham.ac.uk

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

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

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

    So heart failure is important, but what is the aim of the publication and does it succeed? The stated purpose is to “help local health communities and organisations improve the quality and value of the care they deliver.” It attempted this by …

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