[The heart failure management in Sicily: cognitive analysis of clinical features.]

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  • Additional Information
    • Transliterated Title:
      La gestione dello scompenso cardiaco in Sicilia: analisi conoscitiva degli aspetti clinici e organizzativi.
    • Source:
      Publisher: Il Pensiero Scientifico Editore Country of Publication: Italy NLM ID: 0401271 Publication Model: Print Cited Medium: Internet ISSN: 2038-1840 (Electronic) Linking ISSN: 00341193 NLM ISO Abbreviation: Recenti Prog Med Subsets: MEDLINE
    • Publication Information:
      Original Publication: Roma : Il Pensiero Scientifico Editore
    • Subject Terms:
      Cardiology Service, Hospital/*statistics & numerical data ; Coronary Care Units/*statistics & numerical data ; Delivery of Health Care/*statistics & numerical data ; Heart Failure/*therapy; Cardiology Service, Hospital/organization & administration ; Coronary Care Units/organization & administration ; Critical Pathways/statistics & numerical data ; Delivery of Health Care/organization & administration ; Health Care Surveys ; Humans ; Sicily
    • Abstract:
      Introduction: Heart failure (HF) is a main issue of modern healthcare system. Patient affected are continuously growing in number and age; therefore, an integrated management between different parts of healthcare system is crucial to optimize outcome and sustainability. So far, little is known about clinical pathways of HF patients in Sicily.
      Methods: On initiative of the Regional HF Group of the Italian Association of Hospital Cardiologists (ANMCO), we decided to census all the Cardiology Unit of Sicily. A simple questionnaire elaborated by the group and exploring clinical and organizational matters of HF was sent to the Units. The answer arrived on a voluntary basis.
      Results: 41/46 Units sent back the filled questionnaire. Five typologies of units were represented, based on complexity [1. Outpatient units; 2. Units without Intensive Care Unit (ICU); 3. Units with ICU; 4. Units with ICU and Cath Lab; 5. Units with ICU, Cath lab and Cardiac Surgery). A dedicated HF unit is present only in half centers, but it is formally recognized solely in 22% of Units. These Units have scarce dedicated staff and activity is predominantly based on personal initiative. Diagnostic and therapeutic tools are used appropriately in most of them, even though congestion is judged mainly through physical exam and echocardiography. Differently from the indications of the guidelines, post discharge titration of therapy lacks in almost 30% of centers.
      Discussion and Conclusions: In Sicily, HF is managed on a plan mainly based on personal initiative. The quality is sufficiently good but a more appropriate and structured organization in particular of the follow-up seems a necessary and improvable requirement in view of quality measurers and economic sustainability of health care.
    • Publication Date:
      Date Created: 20190206 Date Completed: 20191112 Latest Revision: 20191112
    • Publication Date:
      20221213
    • Accession Number:
      10.1701/3089.30820
    • Accession Number:
      30720015