Abstract 20450: Impact of Addressing Social and Behavioral Factors in Reducing Heart Failure Readmission
Background: United States 30-day hospital readmission rate (RR) for heart failure (HF) is averaging 22.6% and represents a financial burden for CMS and now to hospitals via potential penalties leveraged by Medicare. Efforts to improve RR must identify and treat underlying causes, and these may include social and behavioral factors not heretofore discerned.
Methods: We evaluated multiple social and behavioral factors using validated questionnaires in 74 consecutive patients admitted for HF to determine their prevalence and their possible influence over HF admissions including 30-day readmission. Measures included depression, medication adherence, quantified sodium consumption, heart failure quality of life, sleep-related concerns, and other socio-economic factors including medication affordability and family support. Specific problems were systematically addressed during hospitalization and follow-up. In addition, patients were closely monitored during the 30-days post-discharge with oral diuretics adjusted as needed based in change in daily weight.
Results: The average age was 71±13 years, 61% were male, and the mean ejection fraction was 36 ±19%.
Frequently admitted patients (≥ 2 HF admissions in the last 12 months) differed from standard patients:
The combination of addressing and treating these factors reduced subsequent 30-day readmission from 25% to 12% (p<0.05).
Conclusions: Social and behavioral issues are commonly found in HF patients and are more prevalent in patients with a high frequency of HF hospitalizations. Identifying and systematically addressing these factors can lead to a reduction in hospital utilization.
Author Disclosures: R.V. Milani: None. C.J. Lavie: None. H.O. Ventura: Speakers Bureau; Modest; Otsuka.
- © 2014 by American Heart Association, Inc.