Rural congestive heart failure mortality among US elderly, 1999-2013: Identifying counties with promising outcomes and opportunities for implementation research

作     者：Maria C.Mejia de Grubb Robert S.Levine Barbara Kilbourne Baqar A.Husaini Tyler Skelton Lisa Gittner Michael A.Langston George E.Rust 

作者机构：Department of Family and Community MedicineBaylor College of MedicineHoustonTXUSA Department of SociologyTennessee State UniversityNashvilleTennesseeUSA Center for PreventionResearchTennessee State University College of AgricultureNashvilleTennesseeUSA Department of Political ScienceTexas Tech UniversityLubbockTXUSA Department of Electrical Engineering and Computer ScienceUniversity of TennesseeKnoxvilleTennesseeUSA Department of Family MedicineNational Center for Primary CareMorehouse School of MedicineAtlantaGeorgiaUSA 

出 版 物：《Family Medicine and Community Health》 (家庭医学与社区卫生（英文）)

年 卷 期：2015年第3卷第2期

页      面：27-38页

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1002[医学-临床医学] 1001[医学-基础医学(可授医学、理学学位)] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Congestive heart failure elderly mortality rural 

摘      要：Objective:Describe modern trends in congestive heart failure(CHF)among elderly(65 years of age)in the United States,to identify potentially successful rural *** CHF mortality using multiple-(MCOD)versus underlying-(UCOD)cause of death ***:*** for Disease Control and Prevention mortality files(WONDER internet site).Results:Using MCOD data,overall mortality rates/100,000 population(and 95%confidence intervals)for CHF among persons65 years of age(1999-2013)were 482.0(481.2-482.8)for large central and large fringe metropolitan(LCLF)counties,549.6(548.6-550.7)in small and medium metropolitan(SM)counties,and 652.6(650.9-654.0)in micropolitan and non-core,non-metropolitan(MNCNM)*** positive deviance NCNM counties(collectively including 198,581 residents65 years of age)had an overall CHF rate of 300.9(275.0-326.9)in *** was significantly lower than the LCLF rate for 2013(482.0[481.2-482.8]),and rep-resented a reduction of 47%since *** CHF occurrence as estimated with MCOD was 3.4-fold higher than that obtained with ***:These data illustrate underestimation of CHF by UCOD data and the importance of correct death *** CHF mortality rates are higher than urban rates,but some positive deviance counties demonstrate that this is not *** research is needed to understand the relative contribution of research innovation,medical care,and public health to rural-urban disparities and the relative success of positive deviance counties.