scholarly journals Assessing Hospital Readmission Risk Factors in Heart Failure Patients Enrolled in a Telemonitoring Program

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Adrian H. Zai ◽  
Jeremiah G. Ronquillo ◽  
Regina Nieves ◽  
Henry C. Chueh ◽  
Joseph C. Kvedar ◽  
...  
Keyword(s):  
Heart Failure ◽  
Predictive Value ◽  
Hospital Readmission ◽  
Care Program ◽  
Psychosocial Characteristics ◽  
Heart Failure Patients ◽  
Predictive Algorithm ◽  
Patient Reported ◽  
Study Participants ◽  
The Impact

The purpose of this study was to validate a previously developed heart failure readmission predictive algorithm based on psychosocial factors, develop a new model based on patient-reported symptoms from a telemonitoring program, and assess the impact of weight fluctuations and other factors on hospital readmission. Clinical, demographic, and telemonitoring data was collected from 100 patients enrolled in the Partners Connected Cardiac Care Program between July 2008 and November 2011. 38% of study participants were readmitted to the hospital within 30 days. Ten different heart-failure-related symptoms were reported 17,389 times, with the top three contributing approximately 50% of the volume. The psychosocial readmission model yielded an AUC of 0.67, along with sensitivity 0.87, specificity 0.32, positive predictive value 0.44, and negative predictive value 0.8 at a cutoff value of 0.30. In summary, hospital readmission models based on psychosocial characteristics, standardized changes in weight, or patient-reported symptoms can be developed and validated in heart failure patients participating in an institutional telemonitoring program. However, more robust models will need to be developed that use a comprehensive set of factors in order to have a significant impact on population health.

scholarly journals A Virtual Cardiovascular Care Program for Prevention of Heart Failure Readmissions in a Skilled Nursing Facility Population: A Retrospective Analysis (Preprint)

2021 ◽  
Author(s):  
Daniel Max Friedman ◽  
Jana Marie Goldberg ◽  
Rebecca Lynn Molinsky ◽  
Mark Andrew Hanson ◽  
Adam Castaño ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Readmission ◽  
Readmission Rate ◽  
Hospital Readmissions ◽  
Care Program ◽  
Day Hospital ◽  
Skilled Nursing ◽  
Care Plans ◽  
The Impact ◽  
Cardiovascular Care

BACKGROUND Patients with heart failure (HF) in skilled nursing facilities (SNFs) have 30-day hospital readmission rates as high as 43%. A virtual cardiovascular care program, consisting of patient selection, initial televisit, post-consultation care planning, and follow-up televisits, was developed and delivered by Heartbeat Health, Inc. (HBH), a cardiovascular digital health company, to 11 SNFs (3,510 beds) in New York. The impact of this program on the expected SNF 30-day HF readmission rate is unknown, particularly in the COVID-19 era. OBJECTIVE The aim of the study is to assess whether a virtual cardiovascular care program could improve access to specialty care, thereby reducing the 30-day hospital readmission rate for HF patients discharged to SNF relative to the expected rate for this population. METHODS We performed a retrospective case review of SNF patients who received a virtual cardiology consultation between August 2020 and February 2021. Virtual cardiologists conducted ≥1 telemedicine visit via smartphone, tablet, or laptop device for cardiac patients identified by a SNF care team. Post-consult care plans were communicated to SNF clinical staff. Patients included in this analysis had a preceding index admission for HF. RESULTS We observed lower hospital readmission among patients who received ≥1 virtual consultation compared to the expected readmission rate for both cardiac (3% vs 10%, respectively) and all-cause etiologies (18% vs 27%, respectively) in a population of 3,510 SNF beds. 185 patients (7%) received virtual cardiovascular care via the HBH program, and 40 patients met study inclusion criteria and were analyzed, with 26 (65%) requiring 1 televisit and 14 (35%) requiring more than 1. Cost savings associated with this reduction in readmissions are estimated to be as high as $860 per patient. CONCLUSIONS The investigation provides initial evidence for the potential effectiveness and efficiency of virtual and digitally-enabled virtual cardiovascular care on 30-day hospital readmissions. Further research is warranted to optimize the use of novel virtual care programs to transform delivery of cardiovascular care to high-risk populations.

scholarly journals Correction: Feola, M., et al. Six-Month Predictive Value of Diuretic Resistance Formulas in Discharged Heart Failure Patients after an Acute Decompensation. J. Clin. Med. 2020, 9, 2932

2021 ◽  
Vol 10 (3) ◽  
pp. 531
Author(s):  
Mauro Feola ◽  
Arianna Rossi ◽  
Marzia Testa ◽  
Cinzia Ferreri ◽  
Alberto Palazzuoli ◽  
...  
Keyword(s):  
Heart Failure ◽  
Predictive Value ◽  
Diuretic Resistance ◽  
Heart Failure Patients ◽  
Acute Decompensation

There was an error in the original article [...]

Abstract 149: Care for Heart Failure Patients at the End of Life: Hospital Readmission and Mortality Amongst Heart Failure Patients Discharged to Hospice

2018 ◽  
Vol 11 (suppl_1) ◽  
Author(s):  
Haider J Warraich ◽  
Adam Devore ◽  
Haolin Xu ◽  
Roland Matsouaka ◽  
Paul Heidenreich ◽  
...  
Keyword(s):  
Heart Failure ◽  
End Of Life ◽  
Median Survival ◽  
Hospital Readmission ◽  
Discharge Rate ◽  
Care Plan ◽  
High Risk Population ◽  
White Race ◽  
Heart Failure Patients ◽  
Hospice Patients

Background: While 1 in 10 patients hospitalized with heart failure (HF) die within 30 days, end-of-life care for this high-risk population is not well described. Methods: We analyzed patients discharged alive from the Get With The Guidelines-HF registry between 2005-2014, linked to Medicare claims. We compared patients discharged to hospice to non-hospice “advanced HF” patients (ejection fraction ≤25% and either on inotropes, sodium ≤130, blood urea nitrogen ≥45 mg/dL, systolic blood pressure ≤90 mmHg or comfort measures) and to other GWTG-HF patients. Results: Of 121,990 US patients, hospice patients (n=4588, 2164 facility-based, 2424 home hospice) compared with advanced HF (n=4357) and others (113,045) were older (median age 86 years vs 78 years vs 81 years), more likely white race (88% vs 80% vs 82%), have intravenous loop diuretics used (74% vs 57% vs 63%), have an advanced care plan/surrogate decision maker discussed or documented (76% vs 62% vs 66%), had more dyspnea at rest (55% vs 46% vs 48%) and worse/unchanged symptoms at discharge (35% vs 2% vs 1%) (all p<0.01). Discharge to hospice increased from 2% (n=109) in 2005 to 5% (n=968) in 2014. Median survival in hospice was 11 days (25 th , 75 th percentile: 3, 65 days) compared with advanced HF (318 days) and others (754 days); 34% of patients discharged to a hospice facility and 12% to home hospice died in <3 days. (Figure) Median survival in hospice did not change significantly from 2005 to 2014. Hospital readmission at 30 days was 4% among hospice, 27% for advanced HF, and 22% for others. Median hospice discharge rate was 3.0 (0.7, 5.5). Hospice discharges had lower adjusted hazards of all-cause readmission (hospice compared with others: advanced HF odd ratio (OR) 0.15 (95% confidence interval (CI) 0.13-0.18), others OR 0.15 (95% CI 0.13-0.18). Hospice patients also had lower 6-month and 1-year readmission rate. Non-white race (OR 1.59 [95% CI 1.18-2.17]) and younger age (OR per 5 years 1.18 [95% CI 1.10-1.27)] were the strongest predictors of readmission from hospice. Conclusion: Hospice use in patients hospitalized with HF is limited but increasing. Few hospice patients are rehospitalized and almost a quarter die within 3 days of discharge. These findings may inform interventions to improve hospice care for HF patients.

The impact of cultural and linguistic diversity on hospital readmission in patients hospitalized with acute heart failure

2019 ◽  
Vol 6 (2) ◽  
pp. 121-129
Author(s):  
Michael Seman ◽  
Bill Karanatsios ◽  
Koen Simons ◽  
Roman Falls ◽  
Neville Tan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Hospital Readmission ◽  
Limited English Proficiency ◽  
Linguistic Diversity ◽  
Linguistically Diverse ◽  
Cox Proportional Hazard ◽  
Increased Risk ◽  
Hospital Administrative ◽  
The Impact

Abstract Aims Health services worldwide face the challenge of providing care for increasingly culturally and linguistically diverse (CALD) populations. The aims of this study were to determine whether CALD patients hospitalized with acute heart failure (HF) are at increased risk of rehospitalization and emergency department (ED) visitation after discharge, compared to non-CALD patients, and within CALD patients to ascertain the impact of limited English proficiency (LEP) on outcomes. Methods and results A cohort of 1613 patients discharged from hospital following an episode of acute HF was derived from hospital administrative datasets. CALD status was based on both country of birth and primary spoken language. Comorbidities, HF subtype, age, sex and socioeconomic status, and hospital readmission and ED visitation incidences, were compared between groups. A Cox proportional hazard model was employed to adjust for potential confounders. The majority of patients were classified as CALD [1030 (64%)]. Of these, 488 (30%) were designated as English proficient (CALD-EP) and 542 (34%) were designated CALD-LEP. Compared to non-CALD, CALD-LEP patients exhibited a greater cumulative incidence of HF-related readmission and ED visitation, as expressed by an adjusted hazard ratio (HR) [1.27 (1.02–1.57) and 1.40 (1.18–1.67), respectively]; this difference was not significant for all-cause readmission [adjusted HR 1.03 (0.88–1.20)]. CALD-EP showed a non-significant trend towards increased rehospitalization and ED visitation. Conclusion This study suggests that CALD patients with HF, in particular those designated as CALD-LEP, have an increased risk of HF rehospitalization and ED visitation. Further research to elucidate the underlying reasons for this disparity are warranted.

THE IMPACT OF MITRAL REGURGITATION ON MORTALITY AND HEART FAILURE ADMISSIONS IN NEWLY DIAGNOSED HEART FAILURE PATIENTS

2019 ◽  
Vol 73 (9) ◽  
pp. 1131
Author(s):  
David Patrick Cork ◽  
Hirsch Mehta ◽  
Colin Barker ◽  
Patrick Verta ◽  
Michael P. Ryan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mitral Regurgitation ◽  
Newly Diagnosed ◽  
Heart Failure Patients ◽  
The Impact

scholarly journals Mining telemonitored physiological data and patient-reported outcomes of congestive heart failure patients

PLoS ONE ◽  
2018 ◽  
Vol 13 (3) ◽  
pp. e0190323 ◽  
Author(s):  
Miha Mlakar ◽  
Paolo Emilio Puddu ◽  
Maja Somrak ◽  
Silvio Bonfiglio ◽  
Mitja Luštrek ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Patient Reported Outcomes ◽  
Physiological Data ◽  
Heart Failure Patients ◽  
Patient Reported
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