{
  "abstract": "Heart failure (HF) is a major public health challenge with substantial morbidity, mortality and economic costs, and variability in care and outcomes across England. We aimed to develop and implement a novel heart failure dashboard integrating primary and secondary care data to provide a comprehensive overview of HF management and outcomes for England.Introduction Methods Data were extracted from Hospital Episode Statistics (HES) and the Quality and Outcomes Framework (QOF) for England. Elective and non-elective inpatient admissions for patients without a recorded age <18 years and for whom HF was a recorded diagnosis were interrogated over the four most recent data years. Outpatient appointments were counted if a patient had any diagnosis of HF. HF HES diagnosis was defined by ICD-10 codes (HF: I50.0, I50.1, I50.9, I11.0, I13.0, I13.2 and cardiomyopathy: I25.5, I42.0-I42.9, I43.0-I43.2, I43.8, I51.5, O90.3).Data were analysed using descriptive statistics and presented in an interactive dashboard showing prevalence, admission rates, length of stay (LOS), admission cost (from NHS Tariff Payment System), readmissions, in-hospital mortality, quality metrics and Indices of Multiple Deprivation (IMD).Results Recorded cases of HF increased between 2022/23 and 2023/24 in primary care (620,477 to 672,409) and hospital (706,910 to 750,230), with the ratio of HF cases in primary care vs hospital increasing from 87.8% to 89.6%. During this period, acute HF admissions with a record of inpatient mortality as a portion of HF patients with an admission for any reason decreased from 2.5% to 2.2%.Sub-Integrated Care Board (ICB) acute admissions rates ranged from 9 to 26 admissions per 100 QOF patients (figure 1), and mean LOS ranged from 5.3 to 14.2 days per admission. Sub-ICB readmissions varied from 12.2% to 28.8% of patients hospitalised having ≥1 prior acute HF admission in the previous 365 days. Variation was greater at the Primary Care Network (PCN) level with acute HF admission rates ranging from 6 to 46 admissions per 100 QOF patients, and mean LOS ranging from 2.9 to 20.1 days per admission. At NHS Trust level, acute HF admission mean LOS ranged from 5.3 to 24.9 bed days (figure 2) and the proportion of acute HF admissions (of all acute HF admissions) managed by cardiology ranged from 5.6% to 100%.The dashboard was operationalised to enable users to query the data based on a range of variables including geography, admission type, diagnosis position (primary or any) and patient demographics such as comorbidities or IMD.Conclusions The HF dashboard successfully integrates and allows interactive interrogation of multisource healthcare data in England. HF prevalence and mortality are high, and there is evidence of wide geographic variation in care and outcomes. By examining data across multiple organisational levels, the dashboard could enable targeted resource allocation for HF care quality improvement.Abstract 5-022 Figure 1Sub-ICB emergency HF admission rate per 100 QOF patientsAbstract 5-022 Figure 2Average LOS for emergency HF admission by NHS trust",
  "authors": [
    {
      "affiliations": [
        "Leeds Institute for Data Analytics, University of Leeds, Leeds, UK",
        "Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK",
        "Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK"
      ],
      "name": "CP Gale"
    },
    {
      "affiliations": [
        "Medical and Scientific Affairs, AstraZeneca UK, London, UK"
      ],
      "name": "T Morris"
    },
    {
      "affiliations": [
        "Medical and Scientific Affairs, AstraZeneca UK, London, UK"
      ],
      "name": "K Fairbrother"
    },
    {
      "affiliations": [
        "Medical and Scientific Affairs, AstraZeneca UK, London, UK"
      ],
      "name": "C Thomas"
    }
  ],
  "title": "5-022 Development and implementation of a heart failure dashboard for England: nationwide analysis of 1.4 million primary and secondary health care records",
  "uid": "135d73fc-7e4a-5557-a3bb-283c0a50b139"
}