A CHF clinic. How aggressive outpatient care can offset hospitalization

Congestive heart failure (CHF) is a serious problem, responsible for one of the highest rates of hospitalization in the United States for any medical condition. This study evaluated the effectiveness of a multidisciplinary, outpatient CHF clinic in decreasing the number of hospitalizations that CHF patients required. The clinic combines intensive patient and family education with aggressive follow-up. A major aspect of the research project was developing a computerized database for maintaining the large volume of information generated by the CHF clinic. Once that database was established, records of 20 clinic patients were examined for a 6-month period surrounding each patient's date of enrollment. Characteristics of each patient during the 3-month preclinic period were compared with those of the 3-month postclinic period, including all admissions, all days in the hospital, admissions due to CHF, and days in the hospital due to CHF. There was a mean reduction of 0.733 admissions of all types and a mean reduction of 5.2 inpatient days for all admissions. There was a mean reduction of 0.8 admissions for CHF and a mean reduction of 4.067 inpatient days for CHF. All four reductions were statistically significant (P < .05). Results suggest that the CHF clinic was effective in reducing the number of, and length of stay during, hospitalizations.