Home Monitoring Heart Failure Care Does Not Improve Patient Outcomes: Looking Beyond Telephone-Based Disease Management

@article{Desai2012HomeMH,
  title={Home Monitoring Heart Failure Care Does Not Improve Patient Outcomes: Looking Beyond Telephone-Based Disease Management},
  author={Akshay S. Desai},
  journal={Circulation},
  year={2012},
  volume={125},
  pages={828–836}
}
  • A. Desai
  • Published 14 February 2012
  • Medicine
  • Circulation
Despite considerable advances in evidence-based medical therapy, heart failure continues to contribute a substantial burden of morbidity, mortality, and economic cost to the American healthcare system. After an admission for heart failure management, nearly 25% of patients are readmitted within 30 days, and by 6 months, this proportion reaches nearly 50%.1,2 Medicare payments for unplanned hospital readmissions totaling more than $17 billion account for nearly 15% to 20% of total Medicare… 

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References

SHOWING 1-10 OF 57 REFERENCES

Connecting the circle from home to heart-failure disease management.

There is a growing fiscal and medical imperative for new strategies to smooth the transition from hospital to home for patients, and financial incentives for hospitals to reduce readmissions for cardiovascular disease are established.

Relationship between early physician follow-up and 30-day readmission among Medicare beneficiaries hospitalized for heart failure.

Among patients who are hospitalized for heart failure, substantial variation exists in hospital-level rates of early outpatient follow-up after discharge, and Patients who are discharged from hospitals that have higher early follow- up rates have a lower risk of 30-day readmission.

Recent National Trends in Readmission Rates After Heart Failure Hospitalization

National mean and RSRR distributions among Medicare beneficiaries discharged after hospitalization for heart failure have not changed in recent years, indicating that there was neither improvement in hospital readmission rates nor in hospital variations in rates over this time period.

Patterns of Weight Change Preceding Hospitalization for Heart Failure

Increases in body weight are associated with hospitalization for heart failure and begin at least 1 week before admission and identify a high-risk period during which interventions to avert decompensated heart failure that necessitates hospitalization may be beneficial.

A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failure.

A nurse-directed, multidisciplinary intervention can improve quality of life and reduce hospital use and medical costs for elderly patients with congestive heart failure.

Randomised trial of telephone intervention in chronic heart failure: DIAL trial

This simple, centralised heart failure programme was effective in reducing the primary end point through a significant reduction in admissions to hospital for heart failure.
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