Effectiveness of a Transition Plan at Discharge of Patients Hospitalized with Heart Failure: A Before-and-After Study

Figure 1. Flow diagram of screening and enrolment of participants. Medical records were screened according to discharge date and diagnosis codes. Hospitalizations rejected by the SQLape algorithm were excluded. HF, heart failure; NYHA 1, New York Heart Association functional class 1 (asymptomatic HF); PARE, potentially avoidable readmission.

Figure 2. Rates of hospitalizations followed by a 30 day readmission: comparison of the pre‐intervention and intervention periods among hospitalizations of patients with HF (on the right) and hospitalizations in our internal medicine department of patients without HF (on the left) after being discharged to home. Hospitalizations of patients with HF show an increased rate of all cause readmissions and a decreasing rate of PARE. This leads to a significant reduction of the ratio PARE/total readmissions (P‐value 0.020). During the study period, overall readmission rate increased, while PARE rate remains stable. Red range stands for adjusted expected range of PARE in each group, according to the SQLape® algorithm. PARE, potentially avoidable readmission.

Figure 3. Readmission‐free survival estimates between the receivers and non‐completers groups. Both (A) and (B) show no significant difference at 30 days. PARE, potentially avoidable readmission.

Figure A1. Burden of readmission: more than just a readmission rate, primary outcome takes lengths of stay into account. We considered the ratio of days spent in readmission over all days spent in hospital during the study periods. Each line corresponds to a patient, and each box is a hospitalization with various lengths of stay. Grey boxes are hospitalizations considered as 30 day readmission.

Figure A2. Timeline of the transition plan. Each intervention is described in the Table 1. Many are taking place after decision of discharge and are therefore challenging to provide in time. GP, general practitioner.