A comprehensive hospital discharge and outpatient management program reduced readmission or death by 47% per observation year compared to usual care (95% CI 29-65; P<0.001).
RCT (n=338)
Yes
Does a comprehensive hospital discharge and outpatient management program reduce readmission or death in patients hospitalized for decompensated heart failure?
A comprehensive hospital discharge and outpatient management program significantly reduces readmissions and mortality while improving quality of life and lowering costs in patients hospitalized for decompensated heart failure.
Effect estimate: 47% event reduction (95% CI 29-65)
Absolute Event Rate: 95.1% vs 143.7%
p-value: p=<0.001
AIMS: Disease management programs can reduce hospitalizations in high-risk heart failure (HF) patients, but generalizability to the population hospitalized for HF remains to be proven. We aimed to assess the effectiveness of a discharge and outpatient management program in a non-selected cohort of patients hospitalized for HF. METHODS AND RESULTS: Patients admitted with decompensated HF were randomized to receive usual care (n=174) or an intervention (n=164) consisting of a comprehensive hospital discharge planning and close follow-up at a HF clinic. After a median of 509 days, there were fewer events (readmission or death) in the intervention as compared with the control group (156 vs. 250), which represents 47% (95%CI: 29-65; P<0.001) event reduction per observation year. At 1-year, time to first event, time to first all-cause and HF readmission, and time to death were increased in the intervention group (P<0.001). All-cause and HF readmission rates per observation year were significantly lower, quality of life improved and overall cost of care was reduced in the intervention group. CONCLUSIONS: This comprehensive hospital discharge and outpatient management program prolonged time to first event, reduced hospital readmissions, improved survival and quality of life of patients hospitalized for HF, while reducing cost of management.
Atienza et al. (Tue,) conducted a rct in Decompensated heart failure (n=338). Comprehensive hospital discharge planning and close follow-up at a HF clinic vs. Usual care was evaluated on Readmission or death (47% event reduction, 95% CI 29-65, p=<0.001). A comprehensive hospital discharge and outpatient management program reduced readmission or death by 47% per observation year compared to usual care (95% CI 29-65; P<0.001).