Key result
A general practitioner management plan reduced potentially preventable hospitalisations for heart failure compared to no plan (8.6% vs 10.7% at 1 year; HR 0.77; 95% CI 0.64-0.92; P=0.0051).
Why the study?
Does a general practitioner management plan delay time to next potentially preventable hospitalisation in older patients with heart failure?
Cohort (n=5,979)
Does a general practitioner management plan delay time to next potentially preventable hospitalisation in older patients with heart failure?
Provision of a general practitioner management plan is associated with a significant reduction in potentially preventable hospitalizations for older patients with heart failure.
GP management plans associated with fewer HF hospitalizations; supports hypothesis but leaves open need for randomized confirmation.
BACKGROUND: Several studies have shown that the Australian Medicare-funded chronic disease management programme can lead to improvements in care processes. No study has examined the impact on long-term health outcomes. AIMS: This retrospective cohort study assessed the association between provision of a general practitioner management plan and time to next potentially preventable hospitalisation for older patients with heart failure. METHODS: We used the Australian Government Department of Veterans' Affairs (DVA) claims database and compared patients exposed to a general practitioner management plan with those who did not receive the service. Kaplan-Meier analysis and Cox proportional hazards models were used to compare time until next potentially preventable hospitalisation for heart failure between the exposed and unexposed groups. RESULTS: There were 1993 patients exposed to a general practitioner management plan and 3986 unexposed patients. Adjusted results showed a 23% reduction in the rate of potentially preventable hospitalisation for heart failure at any time (adjusted hazard ratio, 0.77; 95% confidence interval, 0.64 to 0.92; P = 0.0051) among those with a general practitioner management plan compared with the unexposed patients. Within one year, 8.6% of the exposed group compared with 10.7% of the unexposed group had a potentially preventable hospitalisation for heart failure. CONCLUSIONS: A general practitioner management plan is associated with delayed time to next potentially preventable hospitalisation for heart failure.
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Vitry et al. (2014) conducted a cohort in Heart failure (n=5,979). General practitioner management plan vs. No general practitioner management plan was evaluated on Time to next potentially preventable hospitalisation for heart failure (HR 0.77, 95% CI 0.64-0.92, p=0.0051). A general practitioner management plan reduced potentially preventable hospitalisations for heart failure compared to no plan (8.6% vs 10.7% at 1 year; HR 0.77; 95% CI 0.64-0.92; P=0.0051).
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