Outcomes of heart failure hospitalizations at urban teaching vs. Non-Teaching Hospitals: A Nationwide Propensity Score Matched Analysis in the United States
Author Department
Cardiology
Document Type
Article, Peer-reviewed
Publication Date
1-2026
Abstract
Aims: Heart failure (HF) continues to be a major cause of morbidity and mortality worldwide, placing a significant burden on healthcare systems. Differences in the outcomes of HF hospitalizations for adults in teaching vs. non-teaching hospitals in urban settings are uncertain. We evaluated outcomes of HF hospitalizations in patients hospitalized in urban teaching vs. non-teaching hospitals in the United States.
Methods and results: HF hospitalizations were abstracted from the 2016 through 2022 Nationwide Readmissions Database and stratified into urban teaching vs. urban non-teaching hospital settings. Propensity-score matching was used to control for baseline differences between teaching and non-teaching hospital cohorts. Logistic regression and lognormal models were estimated to assess differences in inpatient mortality, length of stay (LOS), total costs, complications, and 30-day and 90-day all-cause readmissions. A total of 7 558 299 weighted HF hospitalizations were included in the analysis, of which 76.3% involved urban teaching hospitalizations. Compared to urban non-teaching, HF hospitalizations in urban teaching hospitals were associated with significantly higher odds of inpatient mortality (OR 1.19, 95% confidence interval [CI]: 1.16-1.22), complications including cardiogenic shock, cardiac arrest, Intra-aortic balloon pump, cardiopulmonary resuscitation, extracorporeal membrane oxygenation and mechanical ventilation use as well as more extended hospital LOS, higher total costs, palliative care consultation and readmissions rates (all P < 0.001). 30-day and 90-day all-cause readmission rates were also statistically higher in teaching hospitals, though the difference was clinically non-significant.
Conclusion: HF hospitalizations in urban teaching hospitals were associated with higher inpatient mortality, complication rates, resource utilization, and palliative care consult rates than urban non-teaching hospitals.
Keywords: Healthcare outcomes; Heart Failure; Hospitalizations; Teaching; United States; Urban.
Recommended Citation
Abdul Jabbar AB, Javed MA, Hall A, Ismayl M, Goldsweig AM, Aboeata A. Outcomes of heart failure hospitalizations at urban teaching vs. Non-Teaching Hospitals: A Nationwide Propensity Score Matched Analysis in the United States. Eur Heart J Open. 2026 Jan 17;6(1):oeag003. doi: 10.1093/ehjopen/oeag003.
PMID
41727909