Mortality due to heart failure and income level

The heart failure It is one of the most common chronic diseases in Spain and one of the main causes of hospital admission. Now, a study published in The Lancet Regional Health – Europe has shown that the chances of dying during an admission for this pathology They can double depending on where you live and your income level..

The work has been funded by the Spanish Society of Cardiology (SEC) and developed by researchers from the Women and Heart group of the SEC itself together with the Institute for the Improvement of Health Care Foundation (IMAS). For this, they were analyzed more than 760,000 hospital admissions for heart failure registered in the National Health System between 2016 and 2022.

This is one of the largest population studies carried out in Europe on this disease within a public health system. The data reflect that each year there are about 255 income per 100,000 inhabitantsapproximately one for every 400 people.

During the period studied, the average mortality during hospitalization was 11.3%which translates into 86,426 deaths, although with large differences between communities.

Income as a key factor

One of the central findings of the study is the direct relationship between regional wealth and clinical outcomes. According to the researchers, for every increase of 1,000 euros in GDP per capitain-hospital mortality due to heart failure drops around 0.77 percentage points.

Regional GDP is also associated with other social determinants of health such as risk of poverty, educational level, unemployment, smoking or obesity. In this way, income acts as a global indicator of the socioeconomic environmentintegrating factors that influence prevention, access to health care and lifestyle habits.

The analysis also took into account healthcare factors such as the complexity of the centers or the annual volume of hospital activity. However, None of these elements showed a significant relationship with mortality when comparing autonomous communities. The socioeconomic context, however, does appear as a key determinant.

Madrid and Andalusia, at the extremes

The differences become especially visible when comparing communities located at opposite poles of income level. Madrid registers the lower hospital mortalitywith 7.7%, while Andalusia reaches 16.4%, which represents a 113% higher mortality. This gap coincides with a difference of 84% in GDP per capitaestimated at around 35,000 euros in Madrid compared to around 19,000 euros in Andalusia.

Between both extremes are communities with figures below the national average, such as Balearics (9.3%), the Basque Country (9.5%) or Catalonia (9.6%), and others with clearly higher rates, such as Estremadura (14.1%), Navarre (13.4%) or Canary Islands (12.9%).

Reduce inequalities

For the main researcher of the study, Carolina Ortizcardiologist at the Alcorcón Foundation University Hospital, “improve living conditions and community resources is as important as the quality of hospital care.

For Francisco Javier Eloladirector of IMAS, the conclusion is unequivocal: “The association between social determinants and hospital health outcomes is the most relevant conclusion of this work and highlights the need to incorporate information on social determinants of health into the electronic medical record of patients”.