RESUMO
BACKGROUND: Over 1.5 million people in Poland suffer from heart failure (HF). The risk of hospitalization is related to environmental and socioeconomic factors and the organization of the healthcare system. AIMS: The study aimed to assess the influence of environmental and socioeconomic factors on the prevalence of hospitalization for HF. METHODS: The impact of environmental and socioeconomic factors on HF hospitalizations in Poland in 2012-2019 based on data from the National Institute of Public Health and Central Statistical Office in Poland was estimated by panel data regression techniques. RESULTS: There were 1 618 734 HF-related hospitalizations (51.3% male; 82.6% aged >65 years). An increase in the number of physicians by 10/10 000 population and healthcare expenditure of 100 PLN per capita resulted in 3.5% (-0.035; 95% confidence interval [CI], -0.06 to -0.01; P = 0.002) and 3% (-0.029; 95% CI, -0.04 to -0.013; P <0.001) decrease in hospitalizations, respectively. For each new outpatient healthcare facility per 10 000 population, there was a 3% (-0.031; 95% CI, -0.048 to -0.014; P <0.001) decrease in hospitalizations. One percentage point increase in the proportion of green areas resulted in a 2.7% (-0.027; 95% CI, -0.042 to -0.01; P = 0.049) decrease in hospitalizations. However, an increase in cars by 1000 inhabitants and a 1 percentage point increase in the unemployment rate were associated with a 6% increase in HF hospitalizations (0.064; 95% CI, 0.008-0.121; P = 0.026). CONCLUSIONS: The number of HF-related hospitalizations has been increasing in the last decade. This trend is most noticeable in regions with low socioeconomic development and poor medical facilities. Our study indicates that health policy measures including environmental and socioeconomic instruments may result in positive health outcomes. Additional analyses are needed to compare the impact of socioeconomic and environmental factors against the impact of healthcare alone.
