Key result
Comprehensive care by a general practitioner significantly reduced the rate of frequent readmission within 6 months compared to cardiologist care in outpatients with stabilized chronic heart failure (8.9% vs 35.5%).
Why the study?
Does outpatient care by a cardiologist compared to a general practitioner reduce readmission rates in patients discharged after a first acute heart failure admission?
Cohort (n=65)
No
Does outpatient care by a cardiologist compared to a general practitioner reduce readmission rates in patients discharged after a first acute heart failure admission?
Absolute Event Rate: 8.9% vs 35.5%
p-value: p=<0.01
Outpatient care by a general practitioner was associated with lower readmission rates compared to specialist cardiologist care for stabilized heart failure patients after their first acute admission.
GP-led care was associated with fewer readmissions in stabilized HF; leaves open optimal model in randomized trials.
OBJECT: The purpose of this study was to elucidate differences in readmission rates and late outcome in outpatients with chronic heart failure treated in different clinical settings. PATIENTS AND METHODS: This study included 65 consecutive patients who were admitted to our CCU due to acute heart failure for the first time and discharged from our institution. After their discharge, 31 were cared for by a cardiologist in the outpatient clinic of our institution (group A) and the other 34 were cared for by a general practitioner in a clinic (group B). The various findings during the acute phase and the follow-up period were retrospectively compared between the two groups. In addition, the incidence of unexpected readmission and prolonged outcomes were compared between the two groups. RESULTS: The patients in group B were older than those in group A, but no other differences were noted in patient characteristics. More patients in group A required more than one hospitalization within 6 months from discharge (group A, 35.5%; group B, 8.9%, p<0.01; follow-up period, 17.1+/-5.9 months). There was no difference in the survival rate between the groups. CONCLUSION: We concluded that stabilized outpatients should receive comprehensive care from a general practitioner to avoid the need for readmission after discharge.
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Sakakibara et al. (1999) conducted a cohort in Chronic Heart Failure (n=65). General practitioner care vs. Cardiologist care was evaluated on More than one hospitalization within 6 months from discharge (p=<0.01). Comprehensive care by a general practitioner significantly reduced the rate of frequent readmission within 6 months compared to cardiologist care in outpatients with stabilized chronic heart failure (8.9% vs 35.5%).
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