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Original Article

Transitions in Health Status in Older Patients with Heart Failure

Marshall H. Chin, MD, MPh, James X. Zhang, PhD, MS, Paul J. Rathouz, PhD
Volume: 96 Issue: 11 November, 2003

Abstract:

Background We aimed to determine transitions in health perception and functional status in older Medicare patients with heart failure. Methods We used 1991 to 1994 data from the Medicare Current Beneficiary Survey, a database that combines Medicare claims with yearly longitudinal surveys. We identified 872 patients 65 years or older in 1991 with a diagnostic code of heart failure. Results At baseline, 58% of the patients rated their general health perception as “fair” or “poor.” Over 1 year, 18% of the patients died. Transition matrices revealed that health perception, activities of daily living, and instrumental activities of daily living were strong correlates of mortality; that dramatic changes in health status were relatively uncommon over 1 year among survivors; and that decline was common in patients with “excellent” or “very good” health perception. The prior year's health status and comorbidity were powerful predictors of the subsequent year's health status. Conclusion Many older patients with heart failure have worsening health status over time. Measures of prior health status can help predict chances of functional recovery.

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