The Heart Failure Clinic: Improving 30-Day All-Cause Hospital Readmissions

Taklalsingh, Nicholas; Wengrofsky, Perry; Levitt, Howard

doi:10.1097/jhq.0000000000000221

Cited by 4 publications

(10 citation statements)

References 35 publications

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“…The clinical outcomes considered in the primary clinical studies included hospitalization, [9][10][11]13 mortality, 9,12,13 guideline-directed medical therapy, 9,10,12 improvement in ejection fraction, 9 primary care and emergency department visits, 10 and medication adherence. 14 The follow-up periods among the included studies ranged from 3 months to 2 years.…”

Section: Discussionmentioning

confidence: 99%

“…The 6 included primary clinical studies comprised 1 prospective cohort study 12 and 5 retrospective cohort studies. [9][10][11]13,14 The studies were published between 2017 and 2020.…”

Section: Methodsmentioning

confidence: 99%

“…The primary clinical studies were conducted by authors from India, 9 Israel, 10,12 and the US. 11,13,14 The economic evaluation studies were conducted by author(s) from Denmark 15 and Canada. 16…”

Section: Country Of Originmentioning

confidence: 99%

“…Three retrospective cohort studies [9][10][11] and 1 prospective cohort study 12 compared multidisciplinary HF clinics with usual care. One retrospective cohort study 13 compared data from a multidisciplinary HF clinic with the Centers for Medicare & Medicaid Services (CMS) data for the national average and surrounding area hospitals, while the other retrospective cohort study 14 compared data of patients attending a multidisciplinary HF clinic with historical controls who did not attend the HF clinic.…”

Section: Interventions and Comparatorsmentioning

confidence: 99%

“…Despite differences in baseline patient characteristics between groups in all included studies, only 2 studies 10,14 adjusted for potential confounders in the analysis, while the other 4 studies did not. 9,[11][12][13] None of studies provided sample size calculations and therefore it was unclear if the studies had sufficient power to detect a statistically significant effect where the P value for a difference being due to chance is less than 5%. Overall, the methodological quality of the included studies was low.…”

Section: Summary Of Critical Appraisalmentioning

confidence: 99%

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Heart Function Clinics for Patients With Heart Failure

Tran¹,

Butcher²

2021

cjht

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Low- to moderate-quality clinical evidence suggested that heart failure clinics were associated with significant reductions in all-cause mortality, reductions in heart failure‒related hospitalization, better guideline-directed medical therapy management, and higher adherence to heart failure medications compared to usual care. The findings for all-cause hospitalization were mixed. One low-quality economic study in Denmark found that heart failure clinics were associated with higher costs but no significant difference in mortality rates compared with the usual care. Another moderate cost-effectiveness analysis study in Canada revealed that heart failure clinic interventions were cost-effective compared to standard care, with an incremental cost-effectiveness ratio below the willingness-to-pay threshold.

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Section: Discussionmentioning

confidence: 99%

“…The 6 included primary clinical studies comprised 1 prospective cohort study 12 and 5 retrospective cohort studies. [9][10][11]13,14 The studies were published between 2017 and 2020.…”

Section: Methodsmentioning

confidence: 99%

Section: Country Of Originmentioning

confidence: 99%

Section: Interventions and Comparatorsmentioning

confidence: 99%

Section: Summary Of Critical Appraisalmentioning

confidence: 99%

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Heart Function Clinics for Patients With Heart Failure

Tran¹,

Butcher²

2021

cjht

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Healthcare Quality Received by Insured Patients in Two Indonesian Regional Public Hospitals

Rachmawaty,

Wahyudin,

Bukhari

et al. 2024

J Holist Nurs

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Background: Hospitals are required to improve the quality of health services provided to patients. Purpose: Evaluating and comparing the healthcare quality received by insured patients hospitalized in two Indonesian regional public hospitals. Methods: Secondary data analysis used the 2019 and 2020 Indonesian National Health Insurance e-claim databases of Hospital A and Hospital B. Descriptive and crosstabs analyses were used to determine INA-CBGs diagnoses that were categorized as high volume, high risk, and high cost. Results: The admissions that caused financial loss at the Hospital A were 21.1% in 2019 and 19.8% in 2020, while 30.3% in 2019 and 27.5% at the Hospital B. More than 60% of these admissions were placed in the 3rd class of inpatient wards of the two hospitals. Of these admissions, < 5% at the Hospital A and >5% at the Hospital B were readmitted within 30 days, although more than 90% were previously discharged based on physicians’ approval. Conclusions: Inadequate healthcare quality received by insured patients. Hence, an integrated clinical pathways based professional nursing practice model is highly recommended to increase patient outcomes and decrease 30 days hospital readmission rates.

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Recent functional decline and outpatient follow-up after hospital discharge: a cohort study

Bogler,

Kirkwood,

Austin

et al. 2023

BMC Geriatr

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Background Functional decline is common following acute hospitalization and is associated with hospital readmission, institutionalization, and mortality. People with functional decline may have difficulty accessing post-discharge medical care, even though early physician follow-up has the potential to prevent poor outcomes and is integral to high-quality transitional care. We sought to determine whether recent functional decline was associated with lower rates of post-discharge physician follow-up, and whether this association changed during the COVID-19 pandemic, given that both functional decline and COVID-19 may affect access to post-discharge care. Method We conducted a retrospective cohort study using health administrative data from Ontario, Canada. We included patients over 65 who were discharged from an acute care facility during March 1st, 2019 – January 31st, 2020 (pre-COVID-19 period), and March 1st, 2020 – January 31st, 2021 (COVID-19 period), and who were assessed for home care while in hospital. Patients with and without functional decline were compared. Our primary outcome was any physician follow-up visit within 7 days of discharge. We used propensity score weighting to compare outcomes between those with and without functional decline. Results Our study included 21,771 (pre-COVID) and 17,248 (COVID) hospitalized patients, of whom 15,637 (71.8%) and 12,965 (75.2%) had recent functional decline. Pre-COVID, there was no difference in physician follow-up within 7 days of discharge (Functional decline 45.0% vs. No functional decline 44.0%; RR = 1.02, 95% CI 0.98–1.06). These results did not change in the COVID-19 period (Functional decline 51.1% vs. No functional decline 49.4%; RR = 1.03, 95% CI 0.99–1.08, Z-test for interaction p = 0.72). In the COVID-19 cohort, functional decline was associated with having a 7-day physician virtual visit (RR 1.15; 95% CI 1.08–1.24) and a 7-day physician home visit (RR 1.64; 95% CI 1.10–2.43). Conclusions Functional decline was not associated with reduced 7-day post-discharge physician follow-up in either the pre-COVID-19 or COVID-19 periods. In the COVID-19 period, functional decline was positively associated with 7-day virtual and home-visit follow-up.

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The Heart Failure Clinic: Improving 30-Day All-Cause Hospital Readmissions

Cited by 4 publications

References 35 publications

Heart Function Clinics for Patients With Heart Failure

Heart Function Clinics for Patients With Heart Failure

Healthcare Quality Received by Insured Patients in Two Indonesian Regional Public Hospitals

Recent functional decline and outpatient follow-up after hospital discharge: a cohort study

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