ArticleClinical research in cardiology : official journal of the German Cardiac Society2019
Higher prevalence of heart failure in rural regions: a population-based study covering 87% of German inhabitants.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Cost-effectiveness of noninvasive telemedical interventional management in patients with heart failure: health economic analysis of the TIM-HF2 trial.Clinical research in cardiology : official journal of the German Cardiac Society · 2022Trial
- Design and rationale of the WE-CARE-HF-CMR trial: Cardiorenal care on wheels for asymptomatic heart failure patients (NCT07185100).Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2026Article
- Rurality, travel distance, and effectiveness of remote patient management in patients with heart failure in the TIM-HF2 trial in Germany: a pre-specified analysis of an open-label, randomised controlled trial.The Lancet regional health. Europe · 2025Article
- Global, regional, and national burden of heart failure and its underlying causes, 1990-2021: results from the global burden of disease study 2021.Biomarker research · 2025Article
- Are Hospital Admissions (Costs) and Mortality Rate Impacted by Guideline-driven Treatment of Heart Failure?: A Comparison between Participants in the "CorBene" CMP and Standard-care Patients on the Basis of Propensity Score Matching.The International journal of angiology : official publication of the International College of Angiology, Inc · 2024Article
- Identifying Predictors of Heart Failure Readmission in Patients From a Statutory Health Insurance Database: Retrospective Machine Learning Study.JMIR cardio · 2024Article
- Sex differences in cardiologic medication provision for adults with coronary heart disease: an analysis of health claims data from 2018 to 2020 in Saxony-Anhalt, Germany.BMC health services research · 2024Article
- German Index of Socioeconomic Deprivation (GISD): Revision, update and applications.Journal of health monitoring · 2022Article
- Review
- 'Time is prognosis' in heart failure: time-to-treatment initiation as a modifiable risk factor.ESC heart failure · 2021 · on this mapReview
- Patients at high risk for a severe clinical course of COVID-19 - small-area data in support of vaccination and other population-based interventions in Germany.BMC public health · 2021Article
- Peripheral artery disease in Germany (2009-2018): Prevalence, frequency of specialized ambulatory care and use of guideline-recommended therapy - A population-based study.The Lancet regional health. Europe · 2021Article
- Multipoint left ventricular pacing with large anatomical separation improves reverse remodeling and response to cardiac resynchronization therapy in responders and non-responders to conventional biventricular pacing.Clinical research in cardiology : official journal of the German Cardiac Society · 2020Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSo far the extent of regional variation of heart failure (HF) prevalence in Germany is unknown.
methodsUsing a full sample of nationwide claims data covering ambulatory care of approximately 87% of the German population, this study aimed to (i) examine regional differences of HF prevalence on the level of 402 German administrative districts and (ii) investigate factors associated with HF prevalence. This study included all statutory health-insured patients aged ≥ 40 years in 2017, comprising about 40 million individuals. Age- and sex-standardized HF prevalence was estimated on the district level. Two-level logistic regression analysis was employed to study the influence of the district-related factors degree of urbanisation and regional socio-economic status on HF diagnosis, adjusted for the individual's age and sex.
resultsHF prevalence in 2017 was 6.0%. Standardized prevalence on the district level varied by a factor of 4.3 (range 2.8-11.9%). Regional socio-economic status and degree of urbanisation were independently associated with HF prevalence. The prevalence increased with decreasing degree of urbanisation. The adjusted risk of suffering from HF was 40% higher in 'rural areas with a low population density' as compared to 'big urban municipalities' (odds ratio 1.40, 99% CI 1.24-1.59).
conclusionStrong regional variations in HF prevalence may inform future public health policies regarding targeted resource planning and prevention strategies. High prevalence in areas with low population density adds to the challenge of ensuring universal access to health services in rural German regions.
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