A community hospital-based congestive heart failure program: impact on length of stay, admission and readmission rates, and cost.

ABSTRACT

OBJECTIVE: To do an analysis of patients with a primary diagnosis of congestive heart failure at discharge before (n = 407) and after (n = 347) the implementation of a comprehensive inpatient and outpatient congestive heart failure program consistent with the guidelines of the Agency for Health Care Policy and Research. STUDY DESIGN: A retrospective analysis of the impact of the congestive heart failure program on length of stay, admission and readmission rates, and costs to both patient and provider. The program, which used a multidisciplinary team approach, included an intensive education program focusing on diet, compliance, and symptom recognition, as well as the use of outpatient infusions. It also incorporated aggressive pharmacologic treatment for patients with advanced congestive heart failure. RESULTS: Our analysis revealed significant decreases in length of stay, admission and readmission rates, and costs to the patient and provider (P < or = .05). The mean cost per admission decreased 17% ($1118), and a substantial 77% ($718,468) net reduction in nonreimbursed (lost) hospital revenue was noted. CONCLUSION: A multidisciplinary, comprehensive congestive heart failure program can improve patient care in a community-hospital setting while significantly reducing costs to both the patient and the institution.