Study Finds Canadian-U.S. Heart Survival Disparity

CHICAGO (Reuters) - U.S. heart failure patients have a better short-term survival rate after hospital treatment than do those in Canada, perhaps because of more intensive initial treatment, according to the findings of a study released on Monday.

But the disparity found 30 days after treatment disappears in a year, perhaps because Canada's system provides better access to follow-up care and prescription drugs for the elderly, researchers at the University of Toronto report.

Heart failure occurs when the heart cannot pump enough blood through the body, for reasons that can include narrowed arteries, high blood pressure and previous heart attacks. Patients, who become short of breath and easily tired, are often treated with drugs, put on modified diets and told to rest.

In a study published in this week's Archives of Internal Medicine, the researchers found that the death rate among heart failure patients in U.S. hospitals after 30 days was 8.9 percent compared with 10.7 percent for similar patients in Canada.

While the difference was statistically significant, after one year nearly one third of patients in both groups had died.

The study involved thousands of older patients in both countries who were hospitalized between 1998 and 2001.

The authors note that the two countries have different health care systems -- the U.S. system is market-controlled with limited government intervention, while the universal single-payer Canadian system covers most physician and hospital services as well as prescription drugs for most people over 65.

The authors note that earlier studies have also found that short-term advantages enjoyed by U.S. heart attack and surgery patients compared with those in Canada were lost in the long run.

"It is plausible that better short-term outcomes in the United States may relate to the intensity of hospital care, and the similar long-term outcomes between the countries may reflect better access in Canada to outpatient follow-up and prescription drugs," the researchers write.

The United States is just starting up a prescription drug program under Medicare, the health care system that covers people at age 65.

"Further studies are needed to explore the reasons underlying this difference in outcomes and to gain additional insights to improve the care and outcomes of heart failure patients in both countries," the researchers concluded.