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Effectiveness and cost of a transitional care program for heart failure: a prospective study with concurrent controls
Brett D Stauffer1, Cliff Fullerton, Neil Fleming
1Institute for Health Care Research and Improvement, Baylor Health Care System, 8080 North Central Expressway, Ste 500, Dallas, TX 75206, USA. Brett.Stauffer@BaylorHealth.edu
Archives of Internal Medicine
|July 27, 2011
Summary
Nurse-led transitional care programs significantly cut heart failure readmissions by 48%. While effective in real-world settings, hospitals may need payment reform for financial sustainability.
Area of Science:
- Cardiology
- Healthcare Management
- Nursing Research
Background:
- Evidence supports nurse-led transitional care for heart failure readmissions.
- Real-world effectiveness in healthcare systems requires further investigation.
Purpose of the Study:
- To evaluate an advanced practice nurse-led transitional care program for heart failure patients aged 65+.
- To assess the program's impact on 30-day readmission rates, length of stay, and 60-day direct costs.
Main Methods:
- Prospective study with concurrent controls at Baylor Medical Center Garland.
- Comparison of readmission rates, length of stay, and costs against other Baylor Health Care System hospitals.
- Budget impact analysis incorporating costs and reimbursement data.
Main Results:
- Significant 48% reduction in adjusted 30-day readmission rates at BMCG.
- Minimal impact on length of stay and total 60-day direct costs.
- A reduction in hospital financial contribution margin of $227 per Medicare heart failure patient.
Conclusions:
- Transitional care programs show promise in reducing heart failure readmissions in real-world settings.
- Financial sustainability for hospitals may necessitate payment reform for such interventions.
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