Use of echocardiography among patients with heart failure: practice variations in Hungarian hospitals.

OBJECTIVE To evaluate some factors, such as demographic factors, disease severity, dissemination of practice guidelines, and hospitals providing medical care, influencing the use of echocardiography among patients with congestive heart failure. DESIGN A 'before-after' controlled epidemiological study based on hospital documentation. SETTING AND PARTICIPANTS A total of 1222 admitted patients with a diagnosis of chronic heart failure from six voluntarily participating hospitals representing each level of in-patient care in Hungary. INTERVENTIONS Implementation of clinical practice guidelines about heart failure developed by the US Agency for Health Care Policy and Research. RESULTS The echocardiography was performed in slightly more than 50% of all cases in the total. The use of echocardiography was different according to age, sex, and hospitals, but no significant difference was found in disease severity and between the two periods of time (before and after the dissemination of the guidelines). CONCLUSIONS This study reveals the existing differences in the use of echocardiography and the lack of essential changes after the dissemination of the guidelines. The distribution and implementation of guidelines needs further investigation.