When heart failure (HF) patients are treated by a cardiologist rather than a hospitalist, their rates of hospital readmissions are lower, according to a new study from the Minneapolis Heart Institute Foundation (MHIF).
Congestive HF is the most common cause of readmissions in patients over 65. Since October, when the CMS begain penalizing hospitals for readmissions, efforts to reduce them have focused on care transitions and post-hospitalization follow-up. To date, there has been limited data on how the attending specialist affects readmission rates, researchers say.
MHIF began research into readmissions five years ago, and discovered that one in five HF patients did not understand their diagnosis, and less than that understood their medication regimen. In addition to improving post-discharge care, hospital officials began looking into whether specialists involved at admissions affected patients’ quality of care and readmission rates.
By analyzing 2,311 CHF patients admitted within a two-year period and analyzing patient demographics, length of stay, time to readmission, hospital attending at time of discharge and total hospital costs based on the attending medical professional at the time of patient discharge, researchers found that 23 percent of patients were readmitted within 30 days of discharge. Readmission rates were significantly lower when the attending physician was a cardiologist as compared to a hospitalist (16 vs. 27 percent). They also found that cardiologists were seeing more severe cases. The study also showed that the median length of stay in the hospital was similar between attending cardiologists and hospitalists (4.8 days vs. 4.2 days), and costs were found to be higher for patients treated by cardiologists ($9,850) than by hospitalists ($7,741.)
Source: Minneapolis Heart Institute Foundation, November 6, 2012
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