| Demographic Group: | Medicare-eligible resident persons aged >=65 years. |
| Numerator: | Hospitalizations (unduplicated*) with principal diagnosis International Classification of Diseases (ICD)-9-CM code 428.0 among Medicare-eligible resident persons aged >=65 years. |
| Denominator: | Residents aged >=65 years who were eligible for Medicare Part A benefits on July 1 of the calendar year, excluding members of health maintenance organizations. |
| Measures of Frequency: | Annual number of persons hospitalized. Annual hospitalization rate — crude and age-adjusted (standardized by the direct method to the year 2000 standard U.S. population, distribution 18†) — with 95% confidence interval. |
| Time Period of Case Definition: | Calendar year. |
| Background: | Congestive heart failure (CHF) is the leading principal diagnosis for Medicare hospital claims. |
| Significance: | Approximately 75% of persons with CHF have antecedent hypertension. During 1979–1996, hospitalizations for CHF increased by 130%. Substantial differences in CHF death rates and preventive measures exist by race, age, sex, place of residence, and other demographic factors. |
| Limitations of Indicator: | Because congestive heart failure is a chronic disease and can have a long preclinical phase, years might pass before changes in behavior or clinical practice affect population morbidity and mortality. |
| Data Resources: | Centers for Medicare and Medicaid Services (CMS) Part A claims data (numerator) and CMS estimates of the population of persons eligible for Medicare (denominator).
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| Limitations of Data Resources: | Diagnoses listed on hospital discharge data might be inaccurate. Practice patterns and payment mechanisms could affect decisions by health-care providers to hospitalize patients. Indicator is limited to Medicare-eligible population. |
| Healthy People 2010 Objectives: | 12-6: Reduce hospitalizations of older adults with congestive heart failure as the principal diagnosis. (12-6a is specific for adults aged 65–74 years; 12-6b is specific for adults aged 75–84 years; 12-6c is specific for adults aged >=85 years.) |
