Analysis

As shown in Chart 1 and Table 1, both the total number and the rate of hospitalizations of Minnesotans due to heart disease have declined since 2005. The number of hospitalizations declined and hospitalization rate was significantly lower each year until the year 2014. Since then, the number of hospitalizations has increased by approximately 5,000. The average annual hospitalization rate has been relatively stable since 2015, rising approximately 5% over four years.

Chart 1: Age-adjusted Hospitalization Rate due to Heart Disease for all Minnesotans, 2005-2018

Table 1: Total Hospitalizations and Hospitalization Rate due to Heart Disease for all Minnesotans, 2005-2018

Year	Number of Hospitalizations	Age-Adjusted Hospitalization Rate (per 100,000)
2005	56,213	1075.9
2006	56,283	1054.5
2007	53,281	977.7
2008	53,360	958.5
2009	50,406	888.1
2010	48,497	840.8
2011	47,118	800.5
2012	47,092	783.4
2013	45,892	745.6
2014	44,135	704.2
2015	44,225	691.8
2016	45,567	698.4
2017	47,835	720.4
2018	49,650	731.3

Since 2005, the rate of heart disease hospitalizations declined across all age groups. Table 2 shows the hospitalization rate by year for younger (ages 18-44), middle-aged (ages 45-64), and older (ages 65+) adults. In each year, the vast majority of hospitalizations is occurring in older adults 65 years and older. Even though there is an overall trend of declining hospitalizations and hospitalization rates since 2005, recent years have shown a slowing or reversal of that trend.

Table 2: Total Hospitalizations and Hospitalization Rate due to Heart Disease for adult Minnesotans by age group, 2005-2018

Year	Number of Hospitalizations, ages 18-44 years	Hospitalization Rate, ages 18-44 years (per 100,000)	Number of Hospitalizations, ages 45-64 years	Hospitalization Rate, ages 45-64 years (per 100,000)	Number of Hospitalizations, ages 65+	Hospitalization Rate, ages 65+ years (per 100,000)
2005	3,365	173.5	16,210	1266.3	36,430	5878.0
2006	3,456	179.0	16,435	1244.9	36,144	5733.5
2007	3,117	162.0	15,623	1152.2	34,297	5339.6
2008	3,082	160.7	15,408	1111.6	34,623	5255.3
2009	2,719	142.5	14,580	1029.1	32,909	4893.6
2010	2,592	136.5	13,833	958.9	31,888	4646.3
2011	2,407	126.4	13,598	930.1	30,935	4413.7
2012	2,525	132.2	13,185	901.9	31,221	4276.9
2013	2,317	120.7	12,815	874.9	30,595	4049.8
2014	2,281	118.5	12,322	839.9	29,362	3765.1
2015	2,286	118.7	12,075	822.4	29,717	3690.1
2016	2,262	117.0	12,634	861.4	30,526	3668.0
2017	2,387	122.3	12,724	872.4	32,539	3786.9
2018	2,437	123.5	13,063	903.4	33,966	3817.3

Chart 2A shows the rate of hospitalizations for heart disease for 18-44 year olds. Between 2005 and 2018, the overall rate dropped by 50 hospitalizations per 100,000 per year, or about 29%. However, the hospitalization rate has remained essentially unchanged from 2013 through 2018.

Chart 2A: Hospitalization Rate due to Heart Disease for Minnesotans ages 18-44, 2005-2018

Chart 2B shows the rate of hospitalizations for heart disease for 45-64 year olds. Between 2005 and 2018, the overall rate dropped by 363 hospitalizations per 100,000 per year, or about 29%. This long-term decline in the hospitalization rate started to slow in 2014, became flat and significantly increased from 2015 to 2016 and again from 2017 to 2018.

Chart 2B: Hospitalization Rate due to Heart Disease for Minnesotans ages 45-64, 2005-2018

Chart 2C shows the rate of hospitalizations for heart disease for individuals 65 years and older. Between 2005 and 2018, the overall rate dropped by 2,061 hospitalizations per 100,000 per year, or about 35%. Like in the younger and middle-aged adults, this long-term decline stopped in recent years, with essentially flat hospitalization rates starting in 2014.

Chart 2C: Hospitalization Rate due to Heart Disease for Minnesotans ages 65+, 2005-2018

Other Resources

• Interactive Atlas of Heart Disease & Stroke
  Online mapping tool from CDC with health indicators (including mortality and hospitalizations), risk factors, social and economic data, health care delivery, insurance, and health care costs data for states and counties. Some census tract data is also available.


• AHRQ HCUPNet
  Online data tool from the Agency for Healthcare Research and Quality (AHRQ) for the Healthcare Cost and Utilization Project (HCUP). Users can download quick tables or create custom queries of national and state-level data on inpatient hospitalization, emergency department, and ambulatory surgery care.


• Heart Attacks at Minnesota Public Health Data Access Portal
  Online data tool from the Minnesota Department of Health showing the heart attack hospitalization rate in Minnesota by 3-year time periods, age group (35 years and older), sex, and county.

Data Source

The data were obtained through the Minnesota Hospital Discharge Dataset, also known as the Minnesota Hospital Uniform Billing (UB) Claims Data, provided to the Health Economics Program at the Minnesota Department of Health by the Minnesota Hospital Association. The dataset captures hospitalizations for Minnesota residents and comes from Minnesota hospitals (except for Federal Hospitals owned by the Veterans Administration or the Indian Health Service) or other states that share data with the state of Minnesota (including the bordering states of Iowa, North Dakota, and South Dakota; hospitalizations that occur in Wisconsin for Minnesota residents are not included/shared). Annual population estimates were obtained through the U.S. Census Bureau in collaboration with the National Center for Health Statistics.

Measure Definition

Heart Disease hospitalizations through September 30, 2015 are identified as the primary discharge code of ICD-9: 390-398, 402, 404, 410-429, including Coronary Heart Disease as ICD-9: 410-414, 429.2, and Congestive Heart Failure as ICD-9: 428. Starting on October 1, 2015, hospitalizations for Heart Disease were identified as the primary discharge diagnosis as ICD-10: I00-I09, I11, I13, I20-I51, including Coronary Heart Disease as ICD-10: I20-I25, and Congestive Heart Failure as I50. This includes the following broad categories: Acute rheumatic fever, chronic rheumatic heart disease, hypertensive heart disease, hypertensive heart and renal disease, ischaemic heart diseases, pulmonary heart disease and diseases of pulmonary circulation, and other forms of heart disease. Patients who are discharged to another hospital are excluded so as to prevent double-counting single events resulting in hospitalizations at multiple facilities.

The change from ICD-9 to ICD-10 introduces some uncertainty in the trend from 2014 through 2016, , because changes in coding may lead to differences in classification of conditions before and after the transition.