Abstract

Heart failure (HF) is a major public health problem requiring timely treatment to reduce hospitalisation and prolong life expectancy. However, there is a lack of information in Estonia regarding the prevalence, diagnostics and treatment practices, and prognosis of heart failure, hindering the effective assessment and improvement of HF management. This analysis was conducted within the framework of the Health Insurance Fund’s treatment pathway accelerator program, which required the mapping of management of incident HF in Estonia within six weeks. Such a rapid analysis was possible thanks to a previously cleaned and standardised dataset, which contained all
healthcare claims, prescriptions, electronic health records, and laboratory test results of 10% of the Estonian population from 2021 to 2019. The incident HF (ICD-10 section I50) cohort included 2,557 people. The primary HF diagnosis was most commonly received from a family doctor (N = 822, 43.5%) or an emergency department (N = 440, 23.3%). During the 6 months before and after the initial diagnosis, natriuretic peptide (BNP, NT-proBNP) measurement and echocardiography were performed in 21.1% (N = 539) of the cohort, while 47.7% had not received either test. Of all the prescriptions issued, 15% were not filled. Medications aimed at improving the prognosis of HF were often prescribed under diagnostic codes other than I50. Within one year, 81.8% of patients received a prescription for a prognosisimproving medication. Despite several limitations, this study demonstrated the potential and value of secondary use of health data in evaluating and planning treatment pathways.