Most Patients Lack Early Follow-Up Care After Heart Failure

Early follow-up care following hospital discharge reduces readmission rates for heart failure patients, but most hospitals have no formal follow-up procedures in place, according to a new study by researchers at the Duke Clinical Research Institute (DCRI).  

In a study of more than 30,000 Medicare beneficiaries hospitalized at 225 hospitals nationwide between 2003 and 2007, fewer than 40% of heart failure patients saw a healthcare provider within seven days of discharge, says Adrian F. Hernandez, MD, a Duke University Medical Center cardiologist who authored the study, which appears in The Journal of the American Medical Association.

Patients who were discharged from hospitals with more consistent follow-up were 15% less likely to be readmitted within 30 days of hospitalization than those who weren’t.

“From what we can tell, there is a lot of room for improvement,” says Hernandez. “A 15- or 20-minute visit with a physician or a physician assistant can go a long way when you compare it to the costs of rehospitalization. Many readmissions can be prevented with a simple process that hospitals and providers can put into place.”

When heart failure patients are hospitalized, doctors may initiate new therapeutic approaches for managing the disease that need to be continued following discharge. However, in the patient’s transition between leaving the hospital and returning home, there is often a communication gap between the various specialists and providers who have ongoing responsibility for optimal treatment, says Hernandez.

“It’s possible during this transition period for miscommunication, or no communication, to take place among in-hospital providers, patients, and their outside providers,” says Hernandez. “If a system is in place to make sure those lines of communication are immediately clear upon discharge, and verified in follow-up, the potential exists to reduce readmission rates.”

A hospital-led follow-up care system ensures the patient’s regular healthcare provider is aware of changes that occurred in the hospital, and is in contact with the patient to make sure they and their caregivers are following the discharge recommendations, including medication compliance, follow-up testing, and discussions about signs and symptoms of worsening conditions.

Patients can do their part too, Hernandez says. “Patients should ask questions, such as, ‘How will my doctor in the clinic know what happened to me during hospitalization? How can I make sure I see a healthcare provider within seven days of discharge?’ It doesn’t matter what type of provider they see—it could be their internist, cardiologist, nurse practitioner, or physician assistant. The most important element is that they see someone early to make sure they are doing okay, that they are taking the right medications, and that everyone is on the same page.”

Source: Duke Medicine News and Communications