One in four hospitalized heart failure patients with Medicare back in hospital within a month 2
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Heart failure occurs when a heart weakened by disease can no longer pump effectively. Before discharge heart failure patients should receive written information on:
• Eating a proper diet;
• Engaging in appropriate physical activity;
• Taking medicines correctly;
• Monitoring their weight; and
• Knowing what to do if their symptoms worsen.
However, the current fee system in the United States doesn’t encourage a focus on prevention researchers said. In their analysis, they report that doctors and hospitals are financially awarded more for treating and hospitalizing patients, not for preventing hospitalizations through such strategies as disease management.
“Physicians aren’t paid to coordinate care,” Ross said. “That physician is busy seeing patients and that’s what they’re paid to do. If we want to deliver better care, this trend is what we need to address.”
Another barrier to optimal care is a lack of communications between doctors who care for patients in the hospital and the patients’ regular physicians who help patients manage their chronic disease, Ross said. The disruption to the continuum of care can negatively affect the patient.
The average age of patients in the study was 80 years and more than half (57 percent) were women. Most patients had multiple chronic diseases: 60 percent had heart arrhythmias; 73 percent had atherosclerosis or hardening of the arteries; 49 percent had diabetes; and 29 percent had kidney failure.
“Coming back and forth into the hospital isn’t good for patients, and it isn’t good for the healthcare system,” said Ross, who plans to research the reasons heart failure patients are readmitted to the hospital. “This is a tremendous challenge.”
Findings of the study are important for patients and hospitals, Ross said.
“Patients should use this information to vet hospitals, to look at the quality of care delivered there and ask questions about the care they receive,” he said. “Hospitals should consider the rehospitalization rate a grade which, from these findings, needs improvement.”