Clinical Epidemiology (Oct 2016)
The Danish Heart Failure Registry
Abstract
Inge Schjødt,1 Anne Nakano,2,3 Kenneth Egstrup,4 Charlotte Cerqueira5 1Department of Cardiology, 2Department of Clinical Epidemiology, Aarhus University Hospital, 3Registry Support Centre of Clinical Quality and Health Informatics (West), Aarhus, 4Department of Cardiology, Odense University Hospital, Svendborg Hospital, Svendborg, 5Registry Support Centre of Epidemiology and Biostatistics (East), Research Centre for Prevention and Health, Capital Region of Denmark, Glostrup, Denmark Aim of database: The aim of the Danish Heart Failure Registry (DHFR) is to monitor and improve the care of patients with incident heart failure (HF) in Denmark. Study population: The DHFR includes inpatients and outpatients ($18 years) with incident HF. Reporting to the DHFR is mandatory for the Danish hospital departments treating patients with incident HF. Final decision to register a patient in the DHFR is made by a cardiologist to ensure the validity of the diagnosis. Approximately 42,400 patients with incident HF were registered in the DHFR in July 2015. Main variables and descriptive data: The main variables recorded in the DHFR are related to the indicators for quality of care in patients with incident HF: performance of echocardiography, functional capacity (New York Heart Association functional classification), pharmacological therapy (angiotensin converting enzyme/angiotensin II antagonist inhibitors, beta-blockers, and mineralocorticoid receptor antagonist), nonpharmacological therapy (physical training, patient education), 4-week readmission rate, and 1-year mortality. Furthermore, basic patient characteristics and prognostic factors (eg, smoking and alcohol) are recorded. At the annual national audit in the DHFR, the indicators and standards for good clinical quality of care for patients with HF are discussed, and recommendations are reported back to clinicians to promote quality improvement initiatives. Furthermore, results and recommendations are communicated to the public in an annual report. All standards for the quality indicators have been met at a national level since 2014. Indicators for treatment status 1 year after diagnosis are under consideration (now prevalent HF). Conclusion: The DHFR is a valuable tool for continuous improvement of quality of care in patients with incident HF in Denmark. Furthermore, it is an important resource for the Danish registry-based HF research.Keywords: heart failure, registry, quality, indicators, processes of care, variables, quality improvement
