Heart failure is one of the most frequent causes of hospitalizations and readmissions in the United States. Several peridischarge interventions were reported to decrease the readmission rates. The objective was to assess the feasibility and effectiveness of a discharge planning intervention to decrease all‐cause readmission rates within 30 days among patients with congestive heart failure (CHF).
We conducted a pilot study as a quality improvement project at a 450‐bed community hospital on patients with a principle diagnosis of CHF. The study was designed as a prospective cohort, using intervention and control groups. The discharge planning intervention included patient teaching, medication reconciliation with detailed discharge instructions, peridischarge planning involving arrangement of home health care, early follow‐up appointments, and follow‐up phone calls. Main study outcomes were readmission rates and mortality within 30 days of discharge. Baseline characteristics and outcomes were compared between intervention and control groups to demonstrate the effect of the intervention.
Baseline characteristics of the intervention and control groups were similar with respect to age, sex, race, type of attending (hospitalist, cardiologist, or other), cardiologist care, ejection fraction, Charlson comorbidity index, and length of stay. We did not detect a statistically significant difference in 30‐day readmission rates (27.6% vs. 24.1%, P = 0.67) between the intervention (n = 58) and control (n = 54) groups. Mortality rates within 30 days were also similar. Although there was no statistically significant difference, the intervention appeared to be relatively protective against readmission in patients < 65 years old, those having ambulatory dysfunction, and those discharged home or to an assisted‐living facility. Time to readmission was also slightly longer in the intervention group (15.5 vs. 9 days, P = 0.07).
Our discharge planning intervention did not demonstrate a significant decrease in 30‐day read‐mission or mortality rates among CHF patients. However, our study confirmed that low‐cost, low‐resource intense interventions are feasible in community hospitals. Extending the study for a longer period may provide statistically significant results, demonstrating the success of the intervention.
B. Cakir ‐ none; G. Gammon ‐ none; J. Abernathy ‐ none; C. Huitt ‐ none; S. Howell ‐ none
To cite this abstract:Cakir B, Gammon G, Abernathy J, Huitt C, Howell S. How Can We Decrease the Readmission Rates of Patients with Congestive Heart Failure?. Abstract published at Hospital Medicine 2011, May 10-13, Dallas, Texas. Abstract 26. Journal of Hospital Medicine. 2011; 6 (suppl 2). https://www.shmabstracts.com/abstract/how-can-we-decrease-the-readmission-rates-of-patients-with-congestive-heart-failure/. Accessed March 31, 2020.