Heart failure education in the emergency department markedly reduces readmissions in un- and under-insured patients.
Am J Emerg Med
; 36(12): 2166-2171, 2018 12.
Article
en En
| MEDLINE
| ID: mdl-29622393
ABSTRACT
BACKGROUND:
Heart failure (HF) readmissions are a longstanding national healthcare issue for both hospitals and patients. Our purpose was to evaluate the efficacy of a structured, educational intervention targeted towards un- and under-insured emergency department (ED) HF patients.METHODS:
HF patients presenting to the ED for care were enrolled between July and December 2015 as part of an open label, interventional study, using a parallel observational control group. Eligible patients provided informed consent, had an established HF diagnosis, and were hemodynamically stable. Intervention patients received a standardized educational intervention in the ED waiting room before seeing the emergency physician, and a 30-day telephone follow-up. Primary and secondary endpoints were 30- and 90-day ED and hospital readmission rates, as well as days alive and out of hospital (DAOH) respectively.RESULTS:
Of the 94 patients enrolled, median age was 58.4â¯years; 40.4% were female, and 54.3% were African American. Intervention patients (nâ¯=â¯45) experienced a 47.8% and 45.3% decrease in ED revisits (Pâ¯=â¯0.02 &Pâ¯<â¯0.001), and 60.0% and 47.4% decrease in hospital readmissions (Pâ¯=â¯0.049 &Pâ¯=â¯0.007) in the 30 and 90â¯days pre- versus post-intervention respectively. Control patients (nâ¯=â¯49) had no change in hospital readmissions or 30-day ED revisits, but experienced a 36.6% increase in 90-day ED revisits (Pâ¯=â¯0.03). Intervention patients also saw a 59.2% improvement in DAOH versus control patients (Pâ¯=â¯0.03).CONCLUSION:
An ED educational intervention markedly decreases ED and hospital readmissions in un- and under-insured HF patients.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Readmisión del Paciente
/
Educación del Paciente como Asunto
/
Insuficiencia Cardíaca
Tipo de estudio:
Observational_studies
Límite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Am J Emerg Med
Año:
2018
Tipo del documento:
Article