Labrosciano, C.Horton, D.Air, T.Tavella, R.Beltrame, J.F.Zeitz, C.J.Krumholz, H.M.Adams, R.J.Scott, I.A.Gallagher, M.Hossain, S.Hariharaputhiran, S.Ranasinghe, I.2025-07-212025-07-212021European Journal of Heart Failure, 2021; 23(1):31-401388-98421388-9842https://hdl.handle.net/2440/146198Aims: National 30-day mortality and readmission rates after heart failure (HF) hospitalisations are a focus of US policy intervention and yet have rarely been assessed in other comparable countries. We examined the frequency, trends and institutional variation in 30-day mortality and unplanned readmission rates after HF hospitalisations in Australia and New Zealand. Methods: and results We included patients >18 years hospitalised with HF at all public and most private hospitals from 2010–15. The primary outcomes were the frequencies of 30-day mortality and unplanned readmissions, and the institutional risk-standardised mortality rate (RSMR) and readmission rate (RSRR) evaluated using separate cohorts. The mortality cohort included 153 592 patients (mean age 78.9±11.8 years, 51.5% male) with 16 442 (10.7%) deaths within 30 days. The readmission cohort included 148 704 patients (mean age 78.6 ±11.9 years, 51.7% male) with 33 158 (22.3%) unplanned readmission within 30 days. In 392 hospitals with at least 25 HF hospitalisations, the median RSMR was 10.7% (range 6.1–17.3%) with 59 hospitals significantly different from the national average. Similarly, in 391 hospitals with at least 25 HF hospitalisations, the median RSRR was 22.3% (range 17.7–27.1%) with 24 hospitals significantly different from the average. From 2010–15, the adjusted 30-day mortality [odds ratio (OR) 0.991/month, 95% confidence interval (CI) 0.990–0.992, P <0.01] and unplanned readmission (OR 0.998/month, 95% CI 0.998–0.999, P <0.01) rates declined. Conclusion: Within 30 days of a HF hospitalisation, one in 10 patients died and almost a quarter of those surviving experienced an unplanned readmission. The risk of these outcomes varied widely among hospitals suggesting disparities in HF care quality. Nevertheless, a substantial decline in 30-day mortality and a modest decline in readmissions occurred over the study period.en© 2020 European Society of CardiologyCardiovascular disease; Heart Failure; Hospitalisation; Policy; ReadmissionHumansHospitalizationPatient ReadmissionAgedAged, 80 and overAustraliaNew ZealandFemaleMaleHeart FailureJournal article10.1002/ejhf.2030552202Labrosciano, C. [0000-0001-5995-4616]Air, T. [0000-0002-4834-4238]Tavella, R. [0000-0002-4869-465X]Beltrame, J.F. [0000-0002-4294-6510]Zeitz, C.J. [0000-0001-8045-6873]Adams, R.J. [0000-0002-7572-0796]