Q J Med 2003; 96: 877-879
© Association of Physicians 2003; all rights reserved.
Editorial |
Should hospitals have a designated consultant with a specific interest in heart failure?
| The first 10% of the full text of this article appears below. |
Chronic heart failure (CHF) is common, costly, disabling and deadly. NICE has recently issued guidelines on its management, and its decompensation is now one of the commonest reasons for acute medical admission to hospital.1,2 Yet its current management is far from optimal: even in the US, only 64% of recommended care is being delivered to CHF patients.3 Not surprisingly, specialists deliver care closer to the guidelines than generalists.4–6 Such specialty-related practice differences may even explain the alarmingly variable differences in outcome for CHF patients between different hospitals: for example, in-patient case fatality in Scotland varies from 8.5% to 23.4%.7
Currently, cardiologists look after large numbers of CHF patients, but the average age of a CHF patient in the UK is now 79 years of
Division of Medicine & Therapeutics Ninewells Hospital & Medical School Dundee e-mail: a.d.struthers@dundee.ac.uk