Universal healthcare but not universal access?

摘要

The global burden of acute heart failure (AHF) has largely remained unchanged over the past several decades.1 North American and European registries suggest one-year post-discharge mortality rates remain unacceptably high. Compared with stable outpatients with chronic heart failure, patients who experience an AHF exacerbation are at increased risk for one-year rehospitalization and mortality. There are many goals during hospitalization, all of which may contribute to this increased risk if not dealt with appropriately, including: 1) identifying and addressing precipitants; 2) treating comorbidities; 3) providing relief from congestion; and 4) arranging outpatient follow-up and prescribing guideline-directed medical therapy (GDMT) to facilitate a safe transition to the outpatient setting