Treatment pathways defined as the sequence of visits to the public health system of patients with cardiomyopathies in Poland in the period 2016-2021.

Background: The diagnosis and management of cardiomyopathies (CMs) are subject to regional variations but no study to date has systematically evaluated the clinical pathways of patients with CMs. Aims: We aimed to assess the management pathway of CM patients in Poland. Methods: This population-based cross-sectional study was conducted based on data from 2016 to 2021 obtained from the national healthcare provider using ICD10 codes to identify CM patients. The treatment pathways of CM patients, defined as the sequence of visits to the public healthcare system and categorized as urgent hospitalization (UH) for disease exacerbation, elective hospitalization (EH), tertiary outpatient medical care (TMC), primary outpatient healthcare (general practice [GP]) were analyzed. Results: Between 2016 and 2021, 65 383 CM patients were analyzed (mean age: 60 years, 65.4% men). Total healthcare services provided to these patients involved hospitalization (47.2%), TMC (16.5%), and GP (27.5%). The first registration CM diagnosis was made on an inpatient basis in 93.4% of patients (UH: 68.1%; EH: 25.1%). The mortality rate during the analyzed period was 39.8% for the total CM population, 43.9% for patients who were registered in the system only once (47% of all subjects), and 65.4% for patients with a Charlson Comorbidity Index ≥ 5. Conclusions: The diagnosis of CMs in Poland is established very late mainly during hospitalization for exacerbation of the disease. This may have an impact on the poor prognosis of CM patients especially those with a high comorbidity burden. This study highlights the urgent need for improvement in CM management in Poland.