The Program Cost Effectiveness of a Safety-Net Hospital Program Expanding Social Needs Activities in Atlanta

Area of Science:

• Cardiology
• Health Services Research
• Public Health

Background:

• The Grady Heart Failure Program (GHFP) is an outpatient service for heart failure patients post-hospitalization.
• Safety-net hospitals face challenges in managing heart failure readmissions.
• Socioeconomic factors significantly impact treatment adherence and outcomes.

Purpose of the Study:

• To evaluate the effectiveness of an expanded Grady Heart Failure Program (GHFP) implemented in 2018.
• To assess the impact of added community health workers, patient liaisons, and home visits on heart failure readmissions.
• To determine the cost-effectiveness of the GHFP from a hospital-provider perspective.

Main Methods:

• A pre-post analysis comparing 2017 and 2018 data for the GHFP.
• Calculation of 30-day all-cause heart failure readmission rates before and after program expansion.
• Assessment of patient follow-up visit rates within seven days of hospital discharge.
• Determination of incremental program cost per averted 30-day heart failure readmission.

Main Results:

• Patient follow-up visits within seven days of discharge increased from 63.7% (2017) to 65.6% (2018).
• 30-day heart failure readmission rates decreased from 15.5% (2017) to 13.1% (2018).
• The incremental cost per averted 30-day readmission was $7,955 in 2018.

Conclusions:

• The expanded GHFP demonstrated a reduction in 30-day heart failure readmissions.
• The program's enhanced support services improved timely follow-up care.
• The GHFP shows potential cost savings for hospitals by reducing inpatient readmission expenses.