Why the study?
Does management on a CHF clinical pathway improve outcomes in older hospitalized patients with congestive heart failure compared to traditional management?
Does management on a CHF clinical pathway improve outcomes in older hospitalized patients with congestive heart failure compared to traditional management?
Implementation of a CHF clinical pathway in older hospitalized patients reduced length of stay and costs but was associated with a concerning increase in readmission rates.
Caution advised before adopting CHF pathways given higher readmissions; leaves open net benefit pending randomized trials.
Congestive heart failure (CHF) is the most common cause for hospitalization in older patients, and the prevalence of this condition is expected to rise as the population ages. The high cost of care has resulted in an increased emphasis on cost-effective approaches in patient management. One way to achieve this is the use of clinical pathways. This article compares outcomes in a group of older hospitalized patients managed on a CHF pathway with those of a historical cohort managed in the traditional manner. The patients on the pathway had significant reductions in length of stay and cost of care as well as more effective delivery of processes of care. Mortality rates were unchanged, at 3.5%. However, readmission rates showed a significant increase, from 9.25% to 13.5%, for patients on the pathway.
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Cardozo et al. (1999) studied this question.