Abstract 1591: Does Recognition of Decompensating Heart Failure and Contact With Health Care Providers Affect Time to Hospitalization?
Purpose: Although the hospitalization rate is known to be high for patients with chronic heart failure (HF), little is known if early recognition of decompensating HF and contact with health care providers affects the patients’ time to hospitalization. The purpose of this study was to compare the time from onset of symptoms to hospitalization for two groups of HF patients: those who contacted their providers for their decompensating HF symptoms prior to hospitalization and those who did not contact a provider before their hospitalization about their HF symptoms.
Methods: Interviews were conducted with 71 chronic HF patients hospitalized for decompensating HF about their symptom experience and interpretation of the meaning of the symptoms (33 contacted their provider about their symptoms and 38 did not contact their provider before hospitalization). Both groups had similar characteristics. Subjects were primarily white males; mean age was 64.2 (SD=14.9).
Results: Subjects in the group who contacted their providers recognized their symptoms as caused by their heart significantly more than the group who did not contact their providers (x=7.97 vs 5.89, p=.005). Those who contacted their providers also believed that there would be adverse consequences if they did not seek care more than the group that did not contact their providers (x=9.15 vs 7.24, p=.005). The group that made contact was hospitalized a mean of 28.7 (SD=58.2) days after onset of symptoms and the non contact group was hospitalized a mean of 20.3 (SD=55.4) days after onset of symptoms (t(69) = −.62, p=.54).
Conclusions: Patients who sought care from their providers prior to hospitalization reported higher cognitive recognition of their decompensating HF symptoms and had a longer time between their symptom onset and hospitalization than those who did not contact their provider. One explanation for this could be that early recognition of decompensating HF and contact with providers resulted in either the providers or the patients or both trying strategies to avoid hospitalization. Further study is needed to determine if contacting a provider actually does lengthen the time until hospitalization for HF patients and what specific patient and/or provider actions resulted in the hospitalization delay.
This research has received full or partial funding support from the American Heart Association, National Center.