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Heart failure disease management in an indigent population
A M O'Connell1, M H Crawford, J Abrams
1University of New Mexico School of Medicine, Albuquerque, NM 87122, USA. aoconne@itsa.icsf.edu
American Heart Journal
|February 15, 2001
Summary
Multidisciplinary disease management programs (MDMP) significantly reduce hospitalizations and improve functional status in indigent heart failure patients not eligible for transplants. These programs also offer substantial cost savings, demonstrating their value in managing complex cases.
Area of Science:
- Cardiology
- Health Services Research
Background:
- Multidisciplinary disease management programs (MDMP) are effective for motivated pre-transplant heart failure patients.
- Limited data exists on MDMP effectiveness in indigent, non-transplant candidate heart failure populations.
Purpose of the Study:
- To evaluate the effectiveness of an MDMP in improving outcomes for indigent heart failure patients.
- To assess the impact of MDMP on hospitalization rates, functional status, and costs in this population.
Main Methods:
- A nonrandomized study of 35 indigent heart failure patients (EF ≤45%) enrolled in an MDMP.
- Patients were divided into two groups: those with high readmission rates (Group A) and those referred for difficult management (Group B).
- Data were compared for the year before and the year after MDMP enrollment.
Main Results:
- Group A: 91% reduction in hospital admissions (33 to 3), improved NYHA class (III-IV to II-III).
- Group B: 0 hospital admissions post-enrollment (previously 9), improved NYHA class (II-III to I-II).
- Net annual cost savings of $162,000 ($4600 per patient) were observed.
Conclusions:
- MDMPs can significantly improve functional status in indigent, non-transplant candidate heart failure patients.
- MDMPs lead to reduced hospitalizations and substantial cost savings compared to conventional care.
- This approach offers a viable strategy for managing complex heart failure in underserved populations.
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