SPC365

Mapping Heart Failure Care in Portugal: Access, Resources, and Regional Inequities

Session: SESSÃO DE COMUNICAÇÕES ORAIS 03 - EPIDEMIOLOGIA E ORGANIZAÇÃO DE CUIDADOS DE SAÚDE
Speaker: Diogo Ferreira

Congress: CPC 2025
Topic: D. Heart Failure
Theme: 10. Chronic Heart Failure
Subtheme: 10.2 Chronic Heart Failure – Epidemiology, Prognosis, Outcome
Session Type: Comunicações Orais
FP Number: ---
Authors: Diogo Rosa Ferreira; João Agostinho; Filipa Almeida; Elisabete Martins

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><strong>Introduction:</strong></span></span><br />
<span style="font-size:11pt"><span style="font-family:Arial,sans-serif">Heart failure (HF) presents a significant public health challenge in Portugal as the prevalence reported in the PORTHOS study is overwhelming. Managing HF requires specialized resources, including dedicated outpatient clinics and trained healthcare professionals. To better understand the current landscape of HF care across the country, a survey was conducted to gather insights into the availability of HF specific services, the distribution of healthcare resources and the challenges faced by medical teams in providing optimal care for HF patients.</span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><strong>Methods:</strong></span></span><br />
<span style="font-size:11pt"><span style="font-family:Arial,sans-serif">A questionnaire was distributed to key medical leaders across all 41 Local Health Units (ULS) of mainland Portugal, as well as to the two autonomous regions. The recipients were either the Head of the HF Clinic, the Cardiology Department Head or the Head of Internal Medicine at each institution. Each center was classified according to the ICARe-HF accreditation program categories.</span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><strong>Results:</strong></span></span><br />
<span style="font-size:11pt"><span style="font-family:Arial,sans-serif">A total of 42 responses were received from the 43 questionnaires sent. There are 8 advanced centers, including 4 Type A and 4 Type B centers, 22 specialized centers, 4 community centers and 8 centers with limited or no cardiology support to HF patients. </span></span><br />
<span style="font-size:11pt"><span style="font-family:Arial,sans-serif">Among the ULS, 22 have dedicated HF outpatient clinics, 10 manage HF patients through general outpatient clinics and 10 do not have any outpatient clinic. Additionally, 25 centers administer ambulatory IV diuretics or IV iron, while 20 centers offer intermittent levosimendan.</span></span><br />
<span style="font-size:11pt"><span style="font-family:Arial,sans-serif">Of the 35 centers offering HF-specific appointments, 27 are conducted by cardiologists (9 in ARS Norte, 6 in ARS Centro, 9 in ARS LVT, 2 in ARS Alentejo, and 1 in ARS Algarve). On average, each of these centers has 3 cardiologists dedicated to HF care, along with 2 dedicated nurses. By analyzing patient numbers in each ARS and using data from the PORTHOS study, we calculated the average number of patients served by each center with HF-specific appointments. The data reveals that the number of patients per center increases from the North to the South of Portugal.</span></span><br />
<span style="font-size:11pt"><span style="font-family:Arial,sans-serif">Sixty-three percent of the ULS have their own HF-specific protocols.</span></span><br />
<span style="font-size:11pt"><span style="font-family:Arial,sans-serif">When asked if the available facilities for treating HF patients were sufficient, 87% of respondents answered &quot;no&quot;. Similarly, 93% indicated that human resources were inadequate, with the primary shortage being in doctors, followed by a lack of nurses.</span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><strong>Conclusion:</strong></span></span><br />
<span style="font-size:11pt"><span style="font-family:Arial,sans-serif">The survey results reveal disparities in the availability of HF-specific care across Portugal&#39;s regions. While some areas are well-equipped with specialized centers and dedicated outpatient clinics, others face substantial challenges due to a lack of resources and specialized personnel. These findings emphasize the importance of addressing regional inequalities to ensure that HF patients receive the necessary care. Further investments in both healthcare facilities and human resources are essential to address the burden of HF in Portugal.</span></span></p>