Congestive Heart Failure in the United States

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Abstract
CONGESTIVE HEART failure (CHF) has been recognized as a major public health problem in the United States,1-4 is associated with substantial morbidity and mortality, and increases exponentially in occurrence with aging. Both the human suffering and the financial burden associated with CHF are substantial. Yet, we know little about the incidence of CHF. Most reports that have documented the occurrence or other aspects of CHF have, by necessity, relied on administrative data, such as the National Hospital Discharge Survey, Medicare databases, and mortality tapes.2-14 When using these data sources, CHF is defined on the basis of diagnostic coding according to the International Classification of Diseases (ICD) system. To the extent that the application and use of the ICD coding system is inaccurate, the current impression of the magnitude of the public health problem posed by CHF may be erroneous. The potential policy implications of reliance on erroneous data are worrisome and include inappropriate allocation of resources for research and provision of preventive and therapeutic services. Therefore, we assessed the validity of the use of ICD codes to identify hospitalizations with clinical evidence of an episode of acute CHF in data of The Corpus Christi Heart Project, a population-based surveillance program for hospitalized coronary heart disease (CHD).