ESTABLISHMENT OF A RAPID ACCESS HEART FAILURE CLINIC TO REDUCE HOSPITAL READMISSIONS
CCC ePoster Library. Le V. 10/26/19; 280532; 297
Vincent Le
Vincent Le
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Abstract
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BACKGROUND: Heart failure (HF) is the most common cause of hospitalization in patients over the age of 65, and hospitalization due to HF represents the single most costly aspect of HF management. Therefore, reducing heart failure admissions has become a critical goal in the management of HF from both a patient and societal perspective. Despite major advances in HF management, the recently published PACT-HF trial still demonstrated a 20% 30-day all cause re-admission rate. This study examined whether patients evaluated by a HF cardiologist in a very early post-discharge HF follow-up clinic, called the quick Heart Failure (qHF) clinic, had a lower than predicted 30-day readmission rate. The clinic aimed to see patients within 4 calendar days of discharge.

METHODS AND RESULTS: A retrospective chart review was conducted for the 67 patients seen in the qHF clinic over a 9-month period between March 1st to December 1st, 2018. Their demographics and clinical characteristics at hospital presentation were used to calculate their risk-standardized estimate of their 30-day all cause readmission rate using the Yale-New Haven Hospital Center for Outcomes Research and Evaluation Heart Failure Readmission Risk Calculator. The mean age of the patients was 76 years. 52% of the patients were male and 36% of the patients had diabetes. The mean creatinine of the patients was 111 μmol/L. The mean and median time to qHF clinic visits from hospital discharge were 7.2 and 4.5 days, respectively. All cause 30-day re-admission rate of the patients seen in the qHF clinic was significantly less than predicted (9% vs 24%, p < 0.001).

CONCLUSION: Patients seen by a HF cardiologist in a very early post-discharge HF follow-up clinic had an all cause 30-day re-admission rate of 9%. This was significantly lower than the predicted 30-day re-admission rate of 24% that was predicted by a validated HF-readmission risk prediction score for this high-risk patient population. Further study is required to identify the specific aspects of the qHF clinic that contributed to the lower re-admission rate and to understand which patients may benefit most from a very early follow-up visit. This may help make the qHF clinic a more cost-effective intervention to reduce hospital re-admission rates for patients admitted with HF.
BACKGROUND: Heart failure (HF) is the most common cause of hospitalization in patients over the age of 65, and hospitalization due to HF represents the single most costly aspect of HF management. Therefore, reducing heart failure admissions has become a critical goal in the management of HF from both a patient and societal perspective. Despite major advances in HF management, the recently published PACT-HF trial still demonstrated a 20% 30-day all cause re-admission rate. This study examined whether patients evaluated by a HF cardiologist in a very early post-discharge HF follow-up clinic, called the quick Heart Failure (qHF) clinic, had a lower than predicted 30-day readmission rate. The clinic aimed to see patients within 4 calendar days of discharge.

METHODS AND RESULTS: A retrospective chart review was conducted for the 67 patients seen in the qHF clinic over a 9-month period between March 1st to December 1st, 2018. Their demographics and clinical characteristics at hospital presentation were used to calculate their risk-standardized estimate of their 30-day all cause readmission rate using the Yale-New Haven Hospital Center for Outcomes Research and Evaluation Heart Failure Readmission Risk Calculator. The mean age of the patients was 76 years. 52% of the patients were male and 36% of the patients had diabetes. The mean creatinine of the patients was 111 μmol/L. The mean and median time to qHF clinic visits from hospital discharge were 7.2 and 4.5 days, respectively. All cause 30-day re-admission rate of the patients seen in the qHF clinic was significantly less than predicted (9% vs 24%, p < 0.001).

CONCLUSION: Patients seen by a HF cardiologist in a very early post-discharge HF follow-up clinic had an all cause 30-day re-admission rate of 9%. This was significantly lower than the predicted 30-day re-admission rate of 24% that was predicted by a validated HF-readmission risk prediction score for this high-risk patient population. Further study is required to identify the specific aspects of the qHF clinic that contributed to the lower re-admission rate and to understand which patients may benefit most from a very early follow-up visit. This may help make the qHF clinic a more cost-effective intervention to reduce hospital re-admission rates for patients admitted with HF.
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