Early Heart Failure Follow-Up Tied to Lower Readmission Rate

Most patients do not receive follow-up care within week; readmission by 30 days less likely if they do
By Rick Ansorge
HealthDay Reporter

TUESDAY, May 4 (HealthDay News) -- Patients who are hospitalized for heart failure are unlikely to have early follow-up after discharge, but those who are discharged from hospitals that have a higher rate of following up within one week have a lower risk of being readmitted within 30 days, according to a study published in the May 5 issue of the Journal of the American Medical Association.

Adrian F. Hernandez, M.D., of the Duke University School of Medicine in Durham, N.C., and colleagues conducted an observational analysis of 30,136 Medicare beneficiaries age 65 and older who were admitted for heart failure and discharged to home from 225 hospitals. Of these, 6,428 (21.3 percent) were readmitted within 30 days.

At the hospital level, the researchers found that a median 38.3 percent of patients had early follow-up (within a week) after discharge from the index hospitalization. In hospitals in the lowest quartile of early follow-up, they found that the 30-day readmission rate was higher (23.3 percent) than in hospitals in the second, third, and fourth quartiles (20.5, 20.5, and 20.9 percent, respectively).

"As we found in this study, a central element of transitional care, outpatient follow-up, varies significantly across hospitals and, for most patients, does not occur in a timely manner," the authors write. "Early evaluation after discharge is critical. This evaluation should include a review of therapeutic changes and a thorough assessment of the patient's clinical status outside of the highly structured hospital setting. Our findings highlight a need for improvement and greater uniformity in coordination of care from inpatient to outpatient settings."

The study was supported in part by an unrestricted educational grant from GlaxoSmithKline and Medtronic; several authors disclosed financial relationships with these and other companies.

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