Table 2. Delivered Care for Heart Failure Patients Comparing Public versus Private.
| Total | Public | Private | p-value | |
|---|---|---|---|---|
| BNP dosage available | 81% (64/79) | 73% (27/37) | 88% (37/42) | 0.087 |
| Indication for BNP | ||||
| Help in the diagnosis | 72% (46/64) | 67% (18/27) | 75% (28/37) | ns |
| Determine the prognosis | 61% (39/64) | 63% (17/27) | 60% (22/37) | ns |
| Help the treatment | 33% (6/27) | 22% (6/27) | 41% (15/37) | ns |
| Monitoring | 58% (37/64) | 48% (13/27) | 65% (24/37) | ns |
| Centers without BNP | ||||
| Lack of access | 80% (13/15) | 80% (8/10) | 100% (5/5) | ns |
| Considered not essential | 20% (3/15) | 30% (3/10) | 0% (0/5) | ns |
| Education program for patient | 33% (24/73) | 55% (17/31) | 22% (7/32) | 0.006 |
| Education program for caregivers | 24% (18/74) | 39% (12/31) | 19% (6/32) | 0.058 |
| Written instructions at hospital discharge | 84% (63/75) | 83% (29/35) | 76% (29/38) | ns |
| By Doctor | 66% (38/58) | 62% (18/29) | 69% (20/29) | ns |
| By Nurse | 33% (19/58) | 38% (11/29) | 28% (8/29) | |
| By Others | 1% (1/58) (1 out of 58) | 0% (0/29) (0 out of 29) | 3% (1/29) (1 out of 29) | |
| Patient monitoring programs | 39% (27/70) | 47% (17/36) | 29% (10/34) | ns |
| Using monitoring program | ||||
| At ambulatory using non-doctorspecialized monitoring | 20% (14/70) | 31% (11/36) | 9% (3/34) | 0.035 |
| At distance using phone or other methods | 14% (10/70) | 14% (5/36) | 15% (5/34) | ns |
| Regular use of HF guidelines | 90% (65/72) | 94% (34/36) | 86% (31/36) | ns |
| DEIC-BSC | 43% (31/72) | 50% (18/36) | 36% (13/36) | ns |
| ESC | 21% (15/72) | 19% (7/36) | 22% (8/36) | |
| AHA/ACC | 17% (12/72) | 14% (5/36) | 16% (7/36) | |
| Institution’s own protocol | 8% (6/72) | 8% (3/36) | 8% (3/36) | |
| Other guidelines | 1% (2/72) | 3% (1/36) | 0% (0/36) | |
| Not following guidelines | 10% (7/72) | 6% (2/36) | 14% (2/36) | |
| Using quality of life questionnaire | 26% (18/69) | 23% (8/35) | 29% (10/34) | ns |
| KCCQ | 3% (2/69) | 3% (1/35) | 3% (1/34) | ns |
| MLHFQ | 20% (14/69) | 17% (6/35) | 24% (8/34) | ns |
| Other | 3% (2/69) | 3% (1/35) | 3% (1/34) | ns |
| Cardiac rehabilitation | 54% (37/68) | 69% (24/35) | 39% (13/33) | 0.016 |
| Key performance indicators | 53% (34/64) | 39% (13/33) | 68% (21/31) | 0.023 |
| Hospital mortality | 31% (20/64) | 22% (7/33) | 42% (13/31) | 0.074 |
| 6-month mortality | 20% (13/64) | 18% (6/33) | 23% (7/31) | ns |
| 30-day hospitalization after discharge | 33% (21/64) | 24% (8/33) | 42% (13/31) | ns |
| 90-day hospitalization after discharge | 14% (9/64) | 12% (4/33) | 16% (5/31) | ns |
| Hospitalization duration | 25% (6/64) | 24% (8/33) | 26% (8/31) | ns |
| Other | 3% (2/64) | 3% (1/33) | 3% (1/31) | ns |
| Medical decision in hospitalized patient in decompensated HF | ||||
| By hospital cardiology team | 44% | 48% | 38% | < 0.001 |
| By cardiologist who cares for the patient in the outpatient clinic | 43% | 41% | 46% | < 0.001 |
| By intensive care unit doctors if admitted in intensive care unit | 13% | 11% | 16% | < 0.001 |
| Beginning of HF treatment | ||||
| Cardiologist in hospital | 38% | 45% | 27% | < 0.001 |
| Cardiologist in ambulatory | 43% | 30% | 62% | < 0.001 |
| General practitioner | 11% | 15% | 4% | < 0.001 |
| Intensive care doctor | 4% | 3% | 5% | 0.102 |
| Geriatrics | 2% | 3% | 0.4% | 0.276 |
| Others | 3% | 4% | 2% | 0.147 |
| Prescribed HF treatment | ||||
| ACE-I | 97% (72/74) | 92% (33/36) | 100% (38/38) | ns |
| ARBs | 84% (62/74) | 81% (29/36) | 87% (33/38) | ns |
| β-blocker | 92% (68/74) | 92% (32/36) | 95% (36/38) | ns |
| Spironolactone | 93% (69/74) | 92% (32/36) | 97% (37/38) | ns |
| Digoxin | 39% (29/74) | 50% (18/36) | 29% (11/38) | 0.064 |
| Diuretics | 88% (65/74) | 86% (31/36) | 90% (34-38) | ns |
| Vasodilators | 51% (38/74) | 58% (21/36) | 45% (17/38) | ns |
| Patients with target doses of medication according guidelines (%) | 73% | 77% | 63% | <0.001 |
IQR, interquartile range; Specialized HF care considered (in-hospital or outpatient);HF, heart failure; HF-DMP, disease management program for HF; Centers with at least one multidisciplinary member , centers having at least one of the following professions: cardiology, nursing, physiotherapy and/or physical educator or nutritionist; HF, heart failure; BNP, brain natriuretic peptide; DEIC, Heart Failure Department of the Brazilian Society of Cardiology; ESC, European Society of Cardiology; AHA, American Heart Association; MDP, multidisciplinary program; KCCQ, Kansas City Cardiomyopathy Questionnaire; MLHFQ, Minnesota Living with Heart Failure questionnaire; ACE-I Angiotensin-converting enzyme inhibitors; ARBs, angiotensin receptor blockers; p, public versus private.