CONCEPT-HF analysis pipeline

The CONCEPT-HF project investigates the effectiveness of care pathways for heart failure (HF) patients across three Spanish healthcare systems (Andalusia, Aragon, Basque Country). The study examines patient trajectories in diagnosis, treatment, and follow-up, benchmarking them against clinical guidelines. Key outcomes include adherence to guidelines, quality improvement strategies based on HF programs, and differences in HF care across regions. The study is observational, retrospective, and cohort-based, covering HF patients treated between 2015 and 2022. Objectives: Describe healthcare pathways for HF patients. Compare observed pathways with guideline-derived theoretical standards. Assess the impact of adherence to guidelines on outcomes. Evaluate HF program strategies based on process and outcome indicators. Analyze regional differences in HF care and outcomes. Analysis Pipeline: Cohort Definition: Includes HF patients aged ≥18 years with hospital admission between 2015–2022. Excludes secondary or primary care-only diagnoses without hospital admissions. Key Variables: HF types, comorbidities, health service utilization, treatments, outcomes (e.g., mortality, hospitalizations). Reference Care Pathways: Based on ESC/AHA guidelines for 2012, 2016, and 2021, covering initial assessment, in-hospital management, treatments, comorbidity management, and multidisciplinary care. Adherence Evaluation: Percentage of clinical criteria met across five categories, weighted equally to calculate a global compliance score. Process Mining: Uses tools like bupaR and ProM to analyze care sequences, conformance to guidelines, and decision factors influencing clinical management. Significance:This study identifies adherence gaps in HF care, informs improvements in patient management, and benchmarks performance across regional healthcare systems, contributing to optimized strategies for chronic disease management.