Key result
Multidisciplinary disease management linked to ~21 percentage point lower 1-year readmissions vs usual care.
Why the study?
Information on the developmental strategies, components, and outcomes of congestive heart failure disease management programs in the Middle Eastern population is limited.
Observational (n=174)
No
Supports multidisciplinary HF programs in similar settings; hypothesis-generating and leaves open need for randomized confirmation.
Aims We aimed to evaluate congestive heart failure (CHF) multidisciplinary disease management program (DMProg) impact on mortality, readmission rates, length of stay (LOS), and gender health characteristics. Methods and results This was a quasi-observational, pre- and post-trial with a parallel nonequivalent group. We enrolled 174 inpatients having CHF with reduced ejection fraction and New York Heart Association (NYHA) Class II–IV, and a total of 197 hospital admissions. A comparative follow-up was performed from 15 December 2014 to 15 December 2015. Among 197 consecutive hospital admissions, 76 (39%) were included in the preintervention or usual care group and 121 (61%) were assigned to the postintervention group. After 1 year, in comparison with the preintervention group, the postintervention group had shorter average LOS in days (7.6 days vs. 11.1 days, p < 0.002), lower 1-year readmission rate (36% vs. 57%, p < 0.003), and lower in-house mortality (1.6% vs. 7.8%, p = 0.03), but similar baseline mortality scores (38.2 vs. 38.6, p = 0.7), 30-day and 90-day readmission rates (15% vs. 18.3%, p = 0.62 and 27.6% vs. 30%, p = 0.65), and 30-day readmission risk score (24.9% vs. 26.2%, p = 0.09). By regression analysis, the DMProg intervention was an independent factor for 1-year readmission reduction ( p = 0.001). Kaplan–Meier survival analysis favored the postintervention group (log-rank, p < 0.001). Conclusion DMProg significantly decreased 1-year readmission rates, LOS, and in-house mortality.
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Salem et al. (2016) conducted an observational in Congestive heart failure with reduced ejection fraction (HFrEF) (n=174). Multidisciplinary disease management program (DMProg) vs. Usual care (preintervention group) was evaluated on 1-year readmission rate (p=<0.003). The multidisciplinary disease management program significantly reduced the 1-year readmission rate to 36% compared to 57% with usual care, and also shortened length of stay and in-house mortality.
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