Regional changes and variability of hospitalization of patients for chronic coronary artery disease in the Russian Federation and its subjects in 2014-2023

Aim. To assess the changes and variability of hospitalization of patients for chronic coronary artery disease (CAD) in the Russian Federation and its subjects in 2014-2023.

Material and methods. We analyzed Rosstat data on the hospitalization structure for CAD/chronic CAD/old myocardial infarction (MI) among adults (18 years and older), contained in table 2000 of the federal statistical observation form № 14 and assessed its changes for 2014-2023. The average regional rates of hospitalization with CAD/chronic CAD/old MI per 100 thousand of the adult population (M±σ), relative values (%) were determined. SPSS 26.0 (IBM Company) and Excel (Microsoft for Microsoft Windows) packages were used for statistical analysis.

Results. The mean regional hospitalization rate of patients due to CAD in 2014 was 1612,0±416,8 per 100 thousand of the adult population, in 2023-1331,8±448,4 per 100 thousand of the adult population (p<0,0001; visibility index 82,7±15%). The mean regional hospitalization rate of patients due to chronic CAD in 2014 was 550,9±325,7 per 100 thousand of the adult population, in 2023-551,4±367,5 per 100 thousand of the adult population (p=0,9; visibility index 107,3±47,4%). The mean regional share of hospitalization due to chronic CAD in the overall hospitalization structure due to CAD in 2014 was 33,4±15,7%, in 2023-39,4±16,2%. The coefficient of variation in hospitalization rate due to CAD increased from 25,8% to 33,7%; due to chronic CAD — from 59,5% to 66,6%. In 2023, compared to 2014, a significant (p<0,0001) increase in old MI contribution to hospitalization rate due to chronic CAD was noted as follows: the mean regional value in 2014 was 25,1±16,7%, and in 2023-32,4±19,3%. In 36 regions, a decrease in the relative and absolute number of hospitalizations of patients due to both CAD and chronic CAD was recorded; in 7 regions, an increase was recorded, while in 39 regions, there were multidirectional changes.

Conclusion. Regional changes in hospitalization rate due to chronic CAD and the contribution of chronic CAD to CAD in Russia as a whole and Russian regions in 2014-2023 vary significantly. No unidirectional changes were noted over a 10-year period. Correct comparison of the indicators over time requires changes in approaches to collecting statistical information. The identified trends may be associated with both approaches to organizing treatment and diagnostic care and the specifics of recording the reasons for hospitalization according to ICD-10 codes. Due to the large number of factors influencing the hospitalizations for chronic CAD, influence of each of them in the context of practical healthcare in Russia should be assessed.

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