An inpatient disease management program for CHF significantly reduced length of stay (3.9 vs. 6.1 days; p<0.0001) and cost per patient ($4404 vs. $6828; p<0.0001) compared to unmanaged care.
Cohort (n=593)
No
Does an inpatient disease management program reduce length of stay and treatment cost in patients with congestive heart failure?
Implementation of an inpatient disease management program for heart failure in a community hospital significantly reduces length of stay and costs while improving guideline adherence.
Absolute Event Rate: 3.9% vs 6.1%
p-value: p=<0.0001
Congestive heart failure (CHF) is a major medical problem with significant hospital costs. The authors developed an inpatient disease management program for CHF in a community hospital setting to determine if it is possible to: 1) increase implementation of Agency for Health Care Policy and Research criteria for CHF; 2) improve the quality of patient care, while lowering length of stay and treatment cost for CHF; and 3) maintain nursing staff satisfaction. The program encompassed a clinical pathway incorporating Agency for Health Care Policy and Research criteria for CHF, CHF education, and patient educational materials. When compared to "unmanaged" patients (n=197) not participating in the algorithm due to physician choice, "managed" patients (n=396) had significantly increased documentation of left ventricular dysfunction and of angiotensin-converting enzyme inhibitor use. In contrast to unmanaged patients, managed patients had a significantly lower length of stay (3. 9+/-2. 2 vs. 6. 1+/-2. 8 days; p<0. 0001) with a significant reduction in cost per patient (4404+/-1989 vs. 6828+/-3347; p<0. 0001). These changes were sustained in follow-up over 1 year and were associated with an improvement in nursing staff education and nursing care. Thus, a disease management program for CHF can be successfully implemented in a general community hospital setting, achieving improved compliance with Agency for Health Care Policy and Research treatment criteria and enhancing patient care, while reducing length of stay and cost.
Discher et al. (Sat,) conducted a cohort in Congestive heart failure (CHF) (n=593). Inpatient disease management program vs. Unmanaged care (physician choice) was evaluated on Length of stay (days) (p=<0.0001). An inpatient disease management program for CHF significantly reduced length of stay (3.9 vs. 6.1 days; p<0.0001) and cost per patient ($4404 vs. $6828; p<0.0001) compared to unmanaged care.