Mental Disorders, Quality of Care, and Outcomes Among Older Patients Hospitalized With Heart Failure

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Abstract
Previous studies have reported that patients with mental illness are at increased risk for developing cardiovascular diseases, including heart failure.1-4 This literature suggests not only an increased risk of incident heart failure but also poorer outcomes after diagnosis. Limited evidence suggests that patients with mental illness and heart failure require more expensive care5 and experience higher rates of hospitalization and mortality than those without psychiatric comorbidities.6-15 Such studies are based on patients drawn from single centers, registries, regions, or other selected patient populations.2,6,7,9-15 Furthermore, although several studies have assessed the effect of depression on heart failure outcomes,6,7,9-15 comparatively few data are available regarding schizophrenia,2 substance abuse, and other types of mental illness.16 Notably absent is an assessment of the specific treatment provided to patients with mental illness and heart failure. Although mental illness is associated with reduced rates of procedure use17 and quality of care18 in patients with myocardial infarction, few comparable data exist for patients with heart failure.

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