Purpose
The purposes of this study were to (1) describe the characteristics of the population
with congestive heart failure (CHF) who were admitted to a large, southeastern, acute-care
hospital and (2) determine which patients are at risk for readmissions within 6 months.
Methods
A descriptive correlational design, using variables maintained in a computerized data
bank on patients with CHF (N = 557, 39% were black) who were admitted between October
2000 and March 2002, was used to describe the adult population with CHF and identify
variables associated with a likelihood of readmission.
Results
In the 6 months after the index admission, 224 (40%) of the patients were readmitted
to the hospital for CHF. Variables significantly associated with readmission included
lack of cardiology consult during admission, living status, point of entry of index
admission, receiving Medicare, and having pulmonary hypertension. Four models, composed
of subsets of variable from the data bank were developed and tested with logistic
regression. The model composed of discharge variables was the only model that predicted
readmission at a significant level.
Conclusions
There is a need to develop comprehensive data banks to describe patterns of care and
their outcomes. Such data should inform plans to manage this vulnerable population.
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References
- Heart Disease and Stroke Statistics-2004 Update. American Heart Association, Dallas (TX)2003
- Racial differences in treatment seeking delays among heart failure patients.J Card Fail. 2002; 8: 381-386
- Race, quality of care, and outcomes of elderly patients hospitalized with heart failure.JAMA. 2003; 289: 2517-2524
- [Hospital readmission in internal medicine].An Med Interna. 2001; 18: 248-254
- Effects of angiotensin-converting enzyme inhibitor therapy on 30-day outcome in patients 65 years of age or older with chronic congestive heart failure.Am J Cardiol. 2000; 86: 1151-1153
- Unplanned readmissions of patients with congestive heart failure.Am J Med. 2000; 109: 386-390
- Predictors of readmission among elderly survivors of admission with heart failure.Am Heart J. 2000; 139: 72-82
- Medical and socioenvironmental predictors of hospital readmission in patients with CHF.Am Heart J. 2001; 142: E7
- Noncardiac comorbidity increases preventable hospitalizations and mortality among Medicare beneficiaries with chronic heart failure.Am J Cardiol. 2003; 42: 1226-1233
- Longer hospital length of stay is not related to better clinical outcomes in congestive heart failure.Am J Manag Care. 1997; 3: 1285-1291
- Improved outcomes from a comprehensive management system for heart failure.Eur J Heart Fail. 2001; 3: 619-625
- The use of beta blockers in heart failure.Ital Heart J. 2000; 1: 996-1002
- Intermittent dobutamine treatment in patients with chronic refractory congestive heart failure.Clin Pharmocol Ther. 1998; 63: 682-685
- Elimination of early rehospitalization in a randomized, controlled trial of multidisciplinary care in a high-risk elderly heart failure population.Eur J Heart Fail. 2001; 3: 209-215
- Quality of care and hospital readmission in congestive heart failure.J Card Fail. 2001; 7: 289-298
- A community hospital-based congestive heart failure program.Am J Managed Care. 1999; 5: 37-43
- Effects of a multidisciplinary, home-based intervention on unplanned readmissions and survival among patients with chronic congestive heart failure.Lancet. 1999; 354: 1077-1083
- Quality of life in individuals with heart failure.Med Care. 2002; 40: 271-282
- Home-based intervention in congestive heart failure. Long-term implications on readmission and survival.Circulation. 2002; 105: 2861-2866
- Socioeconomic status as independent risk factor for hospital readmission for heart failure.Am J Cardiol. 2001; 87: 1367-1371
- Psychosocial issues in patients with congestive heart failure.Prog Cardiovasc Nurs. 2003; 18: 19-27
Alabama Center for Health Statistics. (n.d.). Heart disease deaths and death rates by race and total United States rates: Alabama, 1960–2001. Available from: http://ph.state.al.us/chs/HealthStatistics/Tables/2001/AVS01_39.htm. Accessed April 6, 2003.
- Using data to design systems of care for adults with chronic illness.Manag Care Q. 1996; 4: 46-53
- Multiple regression in behavioral research explanation and prediction. (3rd ed). Harcourt Brace College Publishers, New York1997
- Readmission after hospitalization for congestive heart failure.Arch Intern Med. 1997; 157: 104-110
- Prediction of hospital readmission for heart failure.J Am Coll Cardiol. 1999; 33: 1560-1566
- Case management in a heterogenous congestive heart failure population.Arch Intern Med. 2003; 163: 809-817
- Effect of a standardized nurse case management telephone intervention on resource use in patients with chronic heart failure.Arch Intern Med. 2002; 162: 705-712
- Home-based intervention in congestive heart failure.Circulation. 2002; 105: 2861-2866
- Effectiveness of a team-managed home-based primary care.JAMA. 2000; 284: 2877-2885
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Copyright
© 2005 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
