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Congestive heart failure disease management program: 1-Year population experience from a tertiary center heart
Khal Salem1, Dania Fallata1, Maha ElSebaie2
1Cardiac Centre, King Abdullah Medical City (KAMC), Makkah, aSaudi Arabia.
Insights
A multidisciplinary disease management program (DMProg) for congestive heart failure (CHF) significantly reduced 1-year readmission rates, length of stay (LOS), and in-house mortality in patients. This program offers a promising approach to improve CHF patient outcomes.
Area of Science:
- Cardiology
- Health Services Research
- Public Health
Background:
- Congestive heart failure (CHF) is a major cause of hospitalizations and mortality.
- Effective disease management programs are crucial for improving patient outcomes and reducing healthcare costs.
- Multidisciplinary approaches have shown promise in managing complex chronic conditions like CHF.
Purpose of the Study:
- To evaluate the impact of a multidisciplinary disease management program (DMProg) on key outcomes for patients with CHF.
- To assess the program's effect on mortality, readmission rates, and length of stay (LOS).
- To analyze gender-specific health characteristics within the CHF population.
Main Methods:
- A quasi-observational, pre- and post-intervention study design with a parallel nonequivalent group.
- Inclusion of 174 inpatients with CHF (reduced ejection fraction, NYHA Class II-IV) and 197 hospital admissions.
- Comparative follow-up over one year (December 2014-December 2015) comparing preintervention (usual care) and postintervention groups.
Main Results:
- The postintervention group experienced significantly shorter average LOS (7.6 vs. 11.1 days) and lower 1-year readmission rates (36% vs. 57%).
- In-house mortality was significantly reduced in the postintervention group (1.6% vs. 7.8%).
- Regression analysis identified the DMProg intervention as an independent factor for 1-year readmission reduction (p=0.001), with Kaplan-Meier survival analysis favoring the postintervention group (log-rank, p<0.001).
Conclusions:
- The multidisciplinary disease management program (DMProg) significantly decreased 1-year readmission rates.
- The DMProg intervention led to a significant reduction in length of stay (LOS) for CHF patients.
- The program was effective in reducing in-house mortality among patients with congestive heart failure.
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.