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In most developed countries worldwide, the number of patients with chronic heart failure is growing, with 1–3% of the adult population suffering from this syndrome, rising to about 10% in the very elderly. Because the incidence of heart failure increases with age, its prevalence will greatly increase as our population ages. In the near future a large part of the western population will suffer from heart failure and society will be faced with the financial consequences. Heart failure is consuming about 1.5–2.5% of the health care budget, with approximately 70% of this being spent on hospitalisation.1 On average one in five patients is readmitted within 12 months, making heart failure one of the most common causes of hospitalisation in people over 65 years of age. In a recent international study comparing three states in the USA and three European countries, it was found that among a number of diagnoses, including diabetes, stroke, or hip fracture, the diagnoses of congestive heart failure and chronic obstructive pulmonary disease have the highest hospital readmission rates.2
QUALITY OF LIFE
Not only are readmission rates of heart failure patients higher compared to chronic medical conditions, but also the quality of life of these patients seems to be highly affected. Compared with the healthy general population, heart failure patients show a global reduction in quality of life in several domains (physical functioning, role functioning, and social functioning), reflecting the severe impact of congestive heart failure on daily life, even though some patients are in an ambulatory setting.3
Heart failure reduces quality of life more than any other chronic medical condition (for example, diabetes, arthritis, or chronic lung disease) and patients with multiple conditions have greater decrements in functioning and wellbeing than those with only one condition.3 This decrease in quality of life is not directly …