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Home-Time, Mortality, and Readmissions Among Patients Hospitalized With Heart Failure: A Baseline Prior to
Amber B Tang1, Nicole Solomon2, Karen Chiswell2
1Department of Medicine, University of California Los Angeles (A.B.T.).
Circulation. Heart Failure
|October 9, 2024
Summary
Heart failure patients spent 91.2% of their time alive at home post-discharge. High mortality rates significantly impacted home-time, highlighting a need for improved heart failure management interventions.
Area of Science:
- Cardiology
- Health Services Research
- Patient-Centered Outcomes
Background:
- Home-time, defined as time spent alive outside healthcare facilities, is an emerging patient-centered outcome.
- Limited research exists on home-time in heart failure (HF) patients.
- The impact of quality improvement interventions on HF home-time remains unstudied.
Purpose of the Study:
- To establish baseline home-time metrics for Medicare beneficiaries hospitalized with heart failure.
- To assess post-discharge home-time, mortality, and readmission rates.
- To lay the groundwork for the IMPLEMENT-HF quality improvement program.
Main Methods:
- Analysis of Medicare beneficiaries (≥65 years) hospitalized for heart failure from the Get With the Guidelines-Heart Failure registry (2019-2021).
- Calculation of post-discharge home-time, mortality, and readmission rates at 30 days and 1 year.
- Inclusion of 66,019 patients across 437 sites.
Main Results:
- Median 1-year home-time was 333 days; only 22.1% of patients had 100% home-time.
- Older patients and Black patients experienced significantly less home-time.
- High 1-year rates of heart failure readmission (29.8%) and all-cause mortality (37.0%) were observed.
Conclusions:
- Heart failure patients spent a median of 91.2% of their time alive at home in the year post-discharge.
- High mortality rates were a primary driver of reduced home-time.
- Findings provide a crucial preimplementation baseline for the IMPLEMENT-HF program to evaluate quality improvement initiatives.
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