Psychiatric and psychosocial risks in acutely decompensated chronic heart failure patients
Chronic heart failure is the end stage of many diseases of the heart and has a major negative impact on the American public. While mortality from coronary artery disease (CAD) is declining, the incidence of chronic heart failure is increasing. More than 50% of these cases are a result of CAD or ischemic heart disease (IHD). As of 1999, out of 4.8 million people in the United States living with chronic heart failure, 49% were men and 51% were women.1 Approximately 550 000 new cases of heart failure are diagnosed annually. Experts expect this number to continue to rise as the population ages and as increasing numbers of people survive acute myocardial infarctions (AMIs).2 As a major cause of morbidity and mortality, chronic heart failure is deadly as well as prevalent. Chronic heart failure is now the leading cause for hospitalization in patients > 65 years of age and it is the most costly cardiovascular disease in the United States. Chronic heart failure costs represent the largest single Medicare expenditure, as well as the most common discharge diagnosis for Medicare beneficiaries. In 1998, approximately 1 million chronic heart failure admissions totaled over $7 billion in Medicare spending, with an estimated total cost for chronic heart failure care exceeding $20 billion.3.
