Equity-Efficiency Tradeoff: The Hospital Readmissions Reduction Program And Disparities In Outcomes Among Vulnerable Medicare Heart Failure Patients In Pennsylvania

2020 ◽  
pp. 23-48
Keyword(s):  
Heart Failure ◽  
Hospital Readmissions ◽  
Heart Failure Patients ◽  
Reduction Program

Vulnerable Phase of Acute Heart Failure and its Association with Hospital Readmissions Reduction Program

2021 ◽  
pp. 100904
Author(s):  
Azka Latif ◽  
Noman Lateef ◽  
Scott Lundgren ◽  
Vikas Kapoor ◽  
Muhammad Junaid Ahsan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Hospital Readmissions ◽  
Reduction Program

Redefining Hospital Readmissions to Better Reflect Clinical Course of Care for Heart Failure Patients

2007 ◽  
Vol 22 (2) ◽  
pp. 98-102 ◽  
Author(s):  
Lin Guo ◽  
Eugene S. Chung ◽  
Donald E. Casey ◽  
Richard Snow
Keyword(s):  
Heart Failure ◽  
Clinical Course ◽  
Hospital Readmissions ◽  
Heart Failure Patients

Application of a Marketing Concept to Patient-Centered Care: Co-Producing Health With Heart Failure Patients

2012 ◽  
Vol 17 (2) ◽  
Author(s):  
Robert Leone ◽  
Charles Walker ◽  
Linda Curry ◽  
Elizabeth Agee
Keyword(s):  
Heart Failure ◽  
Hospital Readmissions ◽  
Patient Centered Care ◽  
Future Research ◽  
Marketing Concept ◽  
Patient Centered ◽  
Heart Failure Patients ◽  
Hospital Units ◽  
Effective Discharge ◽  
Centered Care

Increasing numbers of patients are being treated for heart failure each year. One out of four of the heart failure patients who receives care in a hospital is readmitted to the hospital within 30 days of discharge. Effective discharge instruction is critical to prevent these patient readmissions. Co-production is a marketing concept whereby the customer is a partner in the delivery of a good or service. For example, a patient and nurse may partner to co-produce a patient-centered health regimen to improve patient outcomes. In this article we review the cost of treating heart failure patients and current strategies to decrease hospital readmissions for these patients along with the role of the nurse and the concept of co-producing health as related to heart failure patients. Next we describe our study assessing the degree to which discharge processes were co-produced on two hospital units having a preponderance of heart failure patients, and present our findings indicating minimal evidence of co-production. A discussion of our findings, along with clinical implications of these findings, recommendations for change, and suggestions for future research are offered. We conclude that standardized discharge plans lead to a mindset of ‘one size fits all,’ a mindset inconsistent with the recent call for patient-centered care. We offer co-production as a patient-centered strategy for customizing discharge teaching and improving health outcomes for heart failure patients.

RELATIVE EFFECTS OF THE HOSPITAL READMISSIONS REDUCTION PROGRAM FOR CONGESTIVE HEART FAILURE ON HOSPITALS THAT SERVE POORER PATIENTS

2019 ◽  
Vol 73 (9) ◽  
pp. 729
Author(s):  
Jason H. Wasfy ◽  
Vijeta Bhambhani ◽  
Emma Healy ◽  
Christine Choirat ◽  
Francesca Dominici ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Hospital Readmissions ◽  
Reduction Program

scholarly journals CardioMEMS in a Busy Cardiology Practice: Less than Optimal Implementation of a Valuable Tool to Reduce Heart Failure Readmissions

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Robby Singh ◽  
Leon Varjabedian ◽  
Georgy Kaspar ◽  
Marcel Zughaib
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Healthcare Expenditure ◽  
Financial Burden ◽  
Nyha Class ◽  
Hospital Readmissions ◽  
Class Iii ◽  
Current Standard ◽  
Heart Failure Patients ◽  
Cardiovascular Morbidity And Mortality

Introduction. Congestive heart failure is a leading cause of cardiovascular morbidity and mortality that results in a significant financial burden on healthcare expenditure. Though various strategies have been employed to reduce hospital readmissions, one valuable tool that remains greatly underutilized is the CardioMEMS (Abbott), a remote pulmonary artery pressure-monitoring system, which has been shown to help reduce heart failure rehospitalizations in the CHAMPION (CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in NYHA Class III Heart Failure Patients) trial. Methods. ICD-9/ICD-10 codes for chronic heart failure were used to identify patients who presented with congestive heart failure. Of this group, those eligible for CardioMEMS device placement, as based on the CHAMPION trial definition, were selected. Subsequently, a retrospective review of the electronic medical records was completed. All patients were on ACC/AHA guideline-directed medical therapy and had at least one hospital admission for NYHA class III symptoms. Results. 473 patients met the inclusion criteria, of which, 85 patients were found to be eligible for implantation of CardioMEMS device based on the CHAMPION trial definition. Only 18/85 patients received the device, roughly 21%, and the overall CardioMEMS implantation rate was only 4% (18/473) of the total cohort. Conclusion. Despite the benefits to patients and reducing healthcare expenditure, there has been a poor adaptation of this groundbreaking technology. Our study revealed that 79% of eligible heart failure patients did not receive the device. Therefore, efforts need to be undertaken to improve physician and patient education of the device to complement the current standard of care for congestive heart failure.

Noncompliance predicts multiple hospital readmissions in heart failure patients

1999 ◽  
Vol 5 (3) ◽  
pp. 74 ◽  
Author(s):  
Lorraine S. Evangelista ◽  
Lynn V. Docring ◽  
Kathleen Dracup ◽  
Mary A. Woo
Keyword(s):  
Heart Failure ◽  
Hospital Readmissions ◽  
Heart Failure Patients

scholarly journals Using the LACE index to predict hospital readmissions in congestive heart failure patients

2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Hao Wang ◽  
Richard D Robinson ◽  
Carlos Johnson ◽  
Nestor R Zenarosa ◽  
Rani D Jayswal ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Hospital Readmissions ◽  
Heart Failure Patients

scholarly journals Relationships between activation level, knowledge, self-efficacy, and self-management behavior in heart failure patients discharged from rural hospitals

F1000Research ◽  
2015 ◽  
Vol 4 ◽  
pp. 150 ◽  
Author(s):  
Van Do ◽  
Lufei Young ◽  
Sue Barnason ◽  
Hoang Tran
Keyword(s):  
Heart Failure ◽  
Rural Areas ◽  
Self Efficacy ◽  
Hospital Readmissions ◽  
Patient Activation ◽  
Rural Hospitals ◽  
Self Management ◽  
Heart Failure Patients ◽  
Activation Level ◽  
Management Behaviors

Non-adherence to self-management guidelines accounted for 50% of hospital readmissions in heart failure patients. Evidence showed that patient activation affects self-management behaviors in populations living with chronic conditions. The purpose of this study was to describe patient activation level and its relationship with knowledge, self-efficacy and self-management behaviors in heart failure patients discharged from rural hospitals. Our study populations were recruited from two hospitals in rural areas of Nebraska. We found that two-thirds of the participants reported low activation levels (e.g., taking no action to manage their heart failure condition). In addition, low patient activation levels were associated with inadequate heart failure knowledge (p=.005), low self-efficacy (p<.001) and low engagement in heart failure self-management behaviors (p<.001) after discharge from hospital.

scholarly journals Association Between the Hospital Readmissions Reduction Program and Heart Failure Subtype Readmissions and Mortality in the USA

2021 ◽  
pp. 56-66
Author(s):  
Wasiq Sheikh ◽  
Malik Bilal Ahmed ◽  
Anshul Parulkar ◽  
Tamara Lhungay ◽  
Esseim Sharma ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Average Length ◽  
Hospital Readmissions ◽  
Home Healthcare ◽  
Inpatient Mortality ◽  
Readmission Rates ◽  
Reduced Ejection Fraction ◽  
Reduction Program ◽  
The Usa

Background: The Hospital Readmission Reduction Program (HRRP) sought to reduce readmissions by penalising centres with readmissions above the national average, and heart failure (HF) is the leading driver of the readmission penalty. Recent Medicare analyses question the effectiveness of this strategy. This study evaluated the efficacy of HRRP by utilising large national datasets and is the first to analyse based on heart failure subtypes. Methods: Aggregate data was used from the National Inpatient Sample (NIS) to study mortality and the National Readmissions Database (NRD) to study readmissions. Both included all payer-types and were stratified by heart failure subtype and time (pre- and post-HRRP implementation). Results: Patients with HF with preserved ejection fraction (HFpEF) tended to be older females with a higher proportion of comorbidities compared to patients with HF with reduced ejection fraction (HFrEF). In the post-HRRP period, readmission rates decreased for HFrEF (21.4% versus 22.3%, p<0.001) and HFpEF (21.2% versus 22.4%, p<0.001); readmission rates for the two subtypes were not statistically different compared to the other. Post-HRRP, inpatient mortality was consistent for HFrEF (2.8% versus 2.8%, p=0.087), but decreased for HFpEF (2.4% versus 2.5%, p=0.029). There were no significant differences noted in average length of stay. Patients with HFrEF were more frequently discharged to short-term hospitals or home with home healthcare, and patients with HFpEF were discharged to skilled nursing facilities more often. Estimated inpatient costs decreased in both subtypes post-HRRP, but readmission costs were higher for HFrEF. Conclusions: This study suggests that HRRP was associated with minimal change in readmission and inpatient mortality.

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