Follow-Up after Heart Failure Hospitalization: Attendance and Effects of Timing and Provider Type on Readmission Rates
Abstract
ABSTRACT
Objective: The purposes of this study were to: a.) determine differences in demographic, socioeconomic, and clinical variables of adult patients with heart failure that attend follow-up and those who do not and to: b.) to explore the association of the post-discharge follow-up visit components (e.g. the timing of the visit and provider type) with 30-day readmission. Background: Timely follow-up after heart failure hospitalization is an intervention associated with a reduction in 30-day readmission and can improve patient safety; however published studies have shown that the rate of follow-up is low. Research findings describing characteristics of patients at-risk for not attending follow-up and how components of the visit affect 30-day readmissions are limited. Methods: A retrospective chart review of heart failure patients discharged between June 1, 2011 and February 1, 2013 was completed at an urban mid-western acute care hospital. Results: Eighty-five percent of patients (n=68) attended the scheduled follow-up visit. Statistically significant differences were found between the number of outpatient visits in year previous to admission (p= 0.042) and hemoglobin values at admission (p= 0.04) between patients that attended follow-up and those that did not. No statistically significant differences were found between patients that attended follow-up within 3 days, 4-7 days, or 8 or more days and 30-day readmission (p=1.000) or between patients who attended follow-up and were treated by a cardiologist vs. those treated by a primary care provider (p=0.103). Conclusion: Follow-up after heart failure hospitalization remains an important component of care. Interventional studies that facilitate post-discharge follow-up and employ strategies to reduce 30-day readmission need to continue.
Objective: The purposes of this study were to: a.) determine differences in demographic, socioeconomic, and clinical variables of adult patients with heart failure that attend follow-up and those who do not and to: b.) to explore the association of the post-discharge follow-up visit components (e.g. the timing of the visit and provider type) with 30-day readmission. Background: Timely follow-up after heart failure hospitalization is an intervention associated with a reduction in 30-day readmission and can improve patient safety; however published studies have shown that the rate of follow-up is low. Research findings describing characteristics of patients at-risk for not attending follow-up and how components of the visit affect 30-day readmissions are limited. Methods: A retrospective chart review of heart failure patients discharged between June 1, 2011 and February 1, 2013 was completed at an urban mid-western acute care hospital. Results: Eighty-five percent of patients (n=68) attended the scheduled follow-up visit. Statistically significant differences were found between the number of outpatient visits in year previous to admission (p= 0.042) and hemoglobin values at admission (p= 0.04) between patients that attended follow-up and those that did not. No statistically significant differences were found between patients that attended follow-up within 3 days, 4-7 days, or 8 or more days and 30-day readmission (p=1.000) or between patients who attended follow-up and were treated by a cardiologist vs. those treated by a primary care provider (p=0.103). Conclusion: Follow-up after heart failure hospitalization remains an important component of care. Interventional studies that facilitate post-discharge follow-up and employ strategies to reduce 30-day readmission need to continue.