981-46 Impact of a Comprehensive Management Program on the Hospitalization Rate for Patients with Advanced Heart Failure

Fonarow, Gregg C.; Stevenson, Lynne Warner; Walden, Julie; Hamilton, Michèle A.; Natterson, Barbara; Steimle, Anthony; Moriguchi, J.; Middlekauff, Holly R.

doi:10.1016/0735-1097(95)92558-m

Cited by 10 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In 1995, CHF was the leading diagnosis group among hospital discharges. [19][20][21][22] However, application of CHF guidelines remains limited in practice. [12][13][14] Lack of effective CHF diagnosis and therapy and underutilization of effective therapy contribute to CHF hospitalizations.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Heart Failure Disease Management: Impact on Hospital Care, Length of Stay, and Reimbursement

Discher

Klein

Pierce

et al. 2003

Congestive Heart Failure

View full text Add to dashboard Cite

Congestive heart failure (CHF) is a major medical problem with significant hospital costs. The authors developed an inpatient disease management program for CHF in a community hospital setting to determine if it is possible to: 1) increase implementation of Agency for Health Care Policy and Research criteria for CHF; 2) improve the quality of patient care, while lowering length of stay and treatment cost for CHF; and 3) maintain nursing staff satisfaction. The program encompassed a clinical pathway incorporating Agency for Health Care Policy and Research criteria for CHF, CHF education, and patient educational materials. When compared to "unmanaged" patients (n=197) not participating in the algorithm due to physician choice, "managed" patients (n=396) had significantly increased documentation of left ventricular dysfunction and of angiotensin-converting enzyme inhibitor use. In contrast to unmanaged patients, managed patients had a significantly lower length of stay (3.9+/-2.2 vs. 6.1+/-2.8 days; p<0.0001) with a significant reduction in cost per patient ($4404+/-$1989 vs. $6828+/-$3347; p<0.0001). These changes were sustained in follow-up over 1 year and were associated with an improvement in nursing staff education and nursing care. Thus, a disease management program for CHF can be successfully implemented in a general community hospital setting, achieving improved compliance with Agency for Health Care Policy and Research treatment criteria and enhancing patient care, while reducing length of stay and cost.

show abstract

mentioning

confidence: 99%

“…CHF guidelines have been proposed during the last decade to streamline the diagnosis of CHF and improve the efficacy of treatment and the quality of care 19–22 . However, application of CHF guidelines remains limited in practice 15,23 .…”

mentioning

confidence: 99%

Heart Failure Disease Management: Impact on Hospital Care, Length of Stay, and Reimbursement

Discher

Klein

Pierce

et al. 2003

Congestive Heart Failure

View full text Add to dashboard Cite

show abstract

“…In addition, experts have reached consensus and have published guidelines regarding the appropriate management of heart failure. 2,7,8 However, despite compelling medical evidence, the drugs, tests, and recommendations have not been used optimally in all patients. 1,9,10 Although a care path for CHF that included comprehensive and specific recommendations for patient care on each hospital day had been implemented at our institution in 1995, the adherence was low.…”

Section: Arch Internmentioning

confidence: 99%

Impact of a Guideline-Based Disease Management Team on Outcomes of Hospitalized Patients With Congestive Heart Failure

et al. 2001

View full text Add to dashboard Cite

show abstract

“…In a follow up study also from Stevenson's group, Fonarow et al 40 demonstrated in a large series of patients, that the use of hemodynamic monitoring during I.V. vasodilator therapy with nitroprusside alone not only assists in optimizing oral drug therapy but leads to improved Functional Class, increased peak oxygen consumption, and decreased rehospitalization rate.…”

Section: Other Studies Evaluating the Use Of Short Term IV Therapy mentioning

confidence: 99%

Rationale for the Short Term Use of Intravenous Milrinone Under Hemodynamic Guidance in Patients With Severe Systolic Heart Failure

Quigg

2000

Congestive Heart Failure

View full text Add to dashboard Cite

Patients with severe systolic heart failure have a decrease in both number and function of cardiac beta receptors, which may result in a poor inotropic response to I.V. beta-adrenergic agonists such as dobutamine. The I.V. use of the phosphodiesterase inhibitor milrinone, which is a combined positive inotrope/vasodilator in this patient population, is a more rational choice, especially if heart failure is chronic. Many of these patients may also be referred for consideration for cardiac transplantation, for which the use of invasive hemodynamic monitoring is typically necessary to determine whether severe hemodynamic compromise and pulmonary hypertension are reversible with therapy. The use of hemodynamically guided I.V. vasodilator therapy has also been extensively described as a tool to optimize oral vasodilator therapy and predict prognosis in patients evaluated for cardiac transplantation. This review summarizes the important studies supporting the rationale for and benefits of using I.V. milrinone under hemodynamic guidance in this patient population. (c)2000 by CHF, Inc.

show abstract

981-46 Impact of a Comprehensive Management Program on the Hospitalization Rate for Patients with Advanced Heart Failure

Cited by 10 publications

References 0 publications

Heart Failure Disease Management: Impact on Hospital Care, Length of Stay, and Reimbursement

Heart Failure Disease Management: Impact on Hospital Care, Length of Stay, and Reimbursement

Impact of a Guideline-Based Disease Management Team on Outcomes of Hospitalized Patients With Congestive Heart Failure

Rationale for the Short Term Use of Intravenous Milrinone Under Hemodynamic Guidance in Patients With Severe Systolic Heart Failure

Contact Info

Product

Resources

About