Abstract 17951: A Care Transition Bundle for Heart Failure Patients Impacts Hospital Care Access During the 30 Days Following Discharge
Introduction: As the leading cause for hospitalization in patients ≤ 65 years in the US, HF costs are expected to rise by 30% to $9.6 billion by 2030. Medical centers are instituting strategies to improve HF patient transitions from hospital to the community and reduce 30-day all-cause readmissions.
Hypothesis: We hypothesized that implementing key interventions would reduce 30-day readmissions for HF patients as well as the number of ED visits and observation (OBS) stays.
Methods: For all adult primary diagnosis HF patients discharged from our center, we used EMR data to count the number of encounters (inpatient admissions, ED visits, and OBS stays) in the 30 days after discharge. We compared results for consecutive 12 month periods pre- and post-implementation of our intervention bundle, using 2-tailed Z-test to test for statistical significance.
Results: Baseline group was 443 discharges, with 102 readmits, 18 ED visits, and 8 OBS stays in the 30 days post-discharge; post-intervention there were 364 discharges with 56 readmits, 27 ED and 6 OBS visits. Number of readmissions decreased significantly from the pre- to post-intervention periods, dropping from 23.0 to 15.4 per 100 patients (p=0.02). However, this was partially offset by the number of ER visits increasing, from 4.1 to 7.4 per 100 patients (p=0.08). The number of OBS stays stayed approximately constant, from 1.8 to 1.6 per 100 patients (p=0.86). Overall, the total number of hospital encounters decreased, from 28.9 to 24.5 per 100 patients, although the change was not significant (p=0.27).
Hospital Encounters within 30 Days Post-Discharge, per 100 Primary HF Patients
Error bars = 95% confidence intervals
Conclusions: Implementing a care transition bundle for HF patients resulted in a significant (33%) decrease in 30-day all-cause readmissions. ED visits increased, though this was not statistically significant. This suggests that reducing 30-day readmissions may increase use of alternative hospital services.
Author Disclosures: C.M. Thompson: None. C. Kell: None. H. Grossman: None. D. Banerjee: None.
- © 2014 by American Heart Association, Inc.