Key result
Community-based consultant-led CVD care linked to ~66 fewer emergency CVD admissions per 100,000 annually.
Why the study?
The authors sought to examine the effects of a consultant-led, community-based cardiovascular diagnostic, treatment, and rehabilitation service in a highly deprived area on emergency hospital admissions, length of stay, and emergency re-admissions.
Does a consultant-led, community-based cardiovascular service intervention reduce emergency CVD admissions in a highly deprived population?
Cohort (n=588)
Yes
Does a consultant-led, community-based cardiovascular service intervention reduce emergency CVD admissions in a highly deprived population?
Providing integrated, consultant-led, community-based cardiovascular services in highly deprived areas can significantly decrease emergency hospital admissions.
May support community services to cut emergency CVD admissions in deprived areas; hypothesis-generating, needs randomized confirmation before practice change.
OBJECTIVE: To examine the effects on emergency hospital admissions, length of stay and emergency re-admissions of providing a consultant-led, community-based cardiovascular diagnostic, treatment and rehabilitation service, based in a highly deprived area in the North West of England. METHODS: A longitudinal matched controlled study using difference-in-differences analysis compared the change in outcomes in the intervention population, to the change in outcomes in a matched comparison population that had not received the intervention, 5 years before and after implementation. The outcomes were emergency hospitalisations, length of inpatient stay and re-admission rates for cardiovascular disease (CVD). RESULTS: Findings show that the intervention was associated with 66 fewer emergency CVD admissions per 100 000 population per year (95% CI 22.13 to 108.98) in the post-intervention period, relative to the control group. No significant measurable effects on length of stay or emergency re-admission rates were observed. CONCLUSION: This consultant-led, community-based cardiovascular diagnostic, treatment and rehabilitation service was associated with a lower rate of emergency hospital admissions in a highly disadvantaged population. Similar approaches could be an effective component of strategies to reduce unplanned hospital admissions.
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Downing et al. (2019) conducted a cohort in Cardiovascular disease (n=588). Community-based cardiovascular disease service intervention vs. Matched control geographic areas receiving standard fragmented care was evaluated on Emergency cardiovascular disease (CVD) admission rates per 100,000 population per year (DiD estimator -65.56, 95% CI -108.98 to -22.13, p=0.003). A consultant-led, community-based cardiovascular service intervention reduced emergency CVD hospital admissions by 66 per 100,000 population per year.
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