HF patients treated by a cardiologist, rather than hospitalist, have fewer readmissions

November 6, 2012

When a cardiologist attends to heart failure patients, even when the severity of illness is higher, patients have reduced rates of hospital readmissions, compared with those patients who are treated by a hospitalist, according to a trial being presented today at the American Heart Association's scientific sessions in Los Angeles.

(CHF) is the most common cause for hospital readmission in patients over the age of 65 years. Whereas efforts to reduce readmission rates have focused on of care and short-term outpatient follow-up, limited data exist on the impact on what type of specialist is attending to the patient during the admission to reduce these rates.

"Since October 1, 2012, there has been a tremendous national focus on readmission rates, because the Centers for & Medicaid Services began penalizing hospitals for readmissions," explained Casey M. Lawler, MD, a at the Minneapolis Heart Institute (MHI) at Abbott Northwestern Hospital. "However, we at the Minneapolis Heart Institute® began to establish protocols to improve our readmission rates five years ago because we were concerned about providing better patient care; which would then by design have an impact on decreasing preventable readmissions."

In their initial assessments, MHI® healthcare professionals learned that one in five patients did not understand their HF diagnosis, and less than that understood their medication regimen. "Thus, we became much more involved in post-discharge care by phone call within 24 hours of discharge, establishing provider follow-up within three to five days post discharge and having a nurse practitioner follow-up with patients identified as high risk; however, we also wanted to examine whether treatment within the walls of our facility impacted patient care and readmission rates," Lawler said.

In this study, the researchers retrospectively identified all CHF admissions between Jan. 1, 2009, and Dec. 31, 2011. They analyzed patient demographics, length of stay, time to readmission, all patient refined diagnosis related groups, hospital attending at time of discharge and total hospital costs based on the attending medical professional at the time of patient discharge.

Among 2,311 patients, 65 percent of patients were treated by a hospitalist, whereas the remaining 35 percent patients were treated by a cardiologist.

In the analysis, the researchers found that 23.2 percent of patients were readmitted within 30 days of discharge. Readmission rates were significantly lower when the attending physician was a cardiologist as compared to a hospitalist (16 vs. 27.1 percent). They also found that cardiologists were seeing more severe cases.

Median length-of-stay in the hospital was similar between attending cardiologists and hospitalists (4.8 days vs. 4.2 days). After some adjustments, Lawler and his colleagues found that the mean total costs for patients treated by a cardiologist were higher than those treated by a ($9,850 vs. $7,741).

"Although these results reveal that specialists have a positive impact on , an overhaul to an entire healthcare system's treatment of HF patients—from admission to post-discharge follow-up—is required to truly impact preventable readmissions," Lawler said.

Explore further: Hospital readmission rates not accurate measure of care quality

Related Stories

Hospital readmission rates not accurate measure of care quality

August 22, 2011
Avoidable readmissions after discharge from hospital are fairly uncommon and are not an accurate measure of quality of care, found a study in CMAJ (Canadian Medical Association Journal).

Overall hospital admission rates in US linked with high rates of readmission

December 14, 2011
High hospital readmission rates in different regions of the U.S. may have more to do with the overall high use of hospital services in those regions than with the severity of patients' particular conditions or problems in ...

Doctors' decisions on initial hospital admissions may affect readmission rates

May 13, 2011
Researchers compared hospitalization rates and rehospitalization rates of patients admitted for heart attack and for heart failure. Heart attack admissions are considered non-discretionary, whereas, heart failure admissions ...

Device data can ID heart failure patients at readmission risk

October 15, 2012
(HealthDay)—The use of device diagnostics to risk stratify patients during the first seven days after discharge can help identify patients at greatest risk of readmission for heart failure, according to research published ...

Simple, inexpensive risk score can shorten length of stay for patients

October 23, 2012
A simple-to-use risk score can identify low-risk patients following a severe heart attack (STEMI) and may provide an opportunity to employ early discharge strategies to reduce length of hospital stay and save hospital costs ...

Recommended for you

How genes and environment interact to raise risk of congenital heart defects

October 19, 2017
Infants of mothers with diabetes have a three- to five-fold increased risk of congenital heart defects. Such developmental defects are likely caused by a combination of genetic and environmental factors. However, the molecular ...

Mouse studies shed light on how protein controls heart failure

October 18, 2017
A new study on two specially bred strains of mice has illuminated how abnormal addition of the chemical phosphate to a specific heart muscle protein may sabotage the way the protein behaves in a cell, and may damage the way ...

Newborns with trisomy 13 or 18 benefit from heart surgery, study finds

October 18, 2017
Heart surgery significantly decreases in-hospital mortality among infants with either of two genetic disorders that cause severe physical and intellectual disabilities, according to a new study by a researcher at the Stanford ...

Saving hearts after heart attacks: Overexpression of a gene enhances repair of dead muscle

October 17, 2017
University of Alabama at Birmingham biomedical engineers report a significant advance in efforts to repair a damaged heart after a heart attack, using grafted heart-muscle cells to create a repair patch. The key was overexpressing ...

Physically active white men at high risk for plaque buildup in arteries

October 17, 2017
White men who exercise at high levels are 86 percent more likely than people who exercise at low levels to experience a buildup of plaque in the heart arteries by middle age, a new study suggests.

High blood pressure linked to common heart valve disorder

October 17, 2017
For the first time, a strong link has been established between high blood pressure and the most common heart valve disorder in high-income countries, by new research from The George Institute for Global Health at the University ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.