Epidemiological estimates and national infrastructure of heart failure in Mexico: a real-world data analysis of 2,591,278 hospital discharges from the Ministry of Health

Background

Heart failure (HF) is a complex clinical syndrome that leads to serious morbidity and mortality, imposing substantial costs on healthcare systems and societies globally. Then, epidemiological studies are critical to improve clinical practices and outcomes and strengthen healthcare systems.

PUSPOSE: To provide epidemiological estimates of HF related ICD-10 codes using Real-World Data (RWD) from the 2023 Mexican Ministry of Health (MoH) hospitals discharge dataset at a national level.

Methods

We retrospectively analyzed HF discharges in the 2023 MoH open database using heart failure related ICD-10 codes identifying three main codes (I500 – Heart failure, I501- Left ventricular failure, I509 - Heart failure, unspecified). In addition to demographic variables, geographic distribution, discharge motive, and social security affiliation data were collected. We developed an interactive dashboard specifically designed for data analysis and visualization.

Results

Overall, 2,591,278 discharges were reported in the MoH discharge database. Of these, 9,651 (0.37%) were recorded with ICD-10 codes related to HF. Interestingly, HF, unspecified (I509) and congestive heart failure (I500), were the most reported codes, 4,904 (50.81%) and 4,663 (48.31%), respectively. Regarding demographics, male sex (n=4,880 50.6%) with 65 years (IQR 53-76) as median age and married (n=2,964 30.7%) were reported. From the total population, 4.9% reported indigenous origin. Central (n= 3,088 32.0%) and southern (n=2,485 25.7%) regions were the main residence locations; low missing data was reported (2.4%). Improvement (n= 7,741 80.2%) was the main discharge motive followed by death (n= 1,084, 11.2%). 87.9% of cases were recorded as de novo with mean hospital length of 4 days (IQR 2-7) in main ward (93.8%), hospitalized through the emergency room (92.1%) by internal medicine, followed by cardiology, 80.3% and 11.3%, respectively. We identified that the months with the most reported discharges were March (9.7%), January (9.2%), and December (8.7%). Interestingly, 36% of cases did not have healthcare service affiliation, followed by INSABI (28.6%), or unspecified (17.9%)

Conclusion

Our real-world big data study suggests that despite HF being a significant condition, especially for MoH emergency and internal medicine services, it is underreported considering the global burden of disease. In addition, HF possesses a high mortality rate per hospitalization, and in most cases, there is no health coverage. These findings can drive strategies focused on primary care to mitigate the burden of disease and improve outcomes at the national level.