Effect of Home-Based Intervention on Hospital Readmission and Quality of Life in Middle-Aged Patients with Severe Congestive Heart Failure: A 12-Month Follow Up Study

Vavouranakis, Ioannis; Lambrogiannakis, E.; Markakis, George; Dermitzakis, Aris; Haroniti, Z.; Ninidaki, C.; Borbantonaki, A.; Tsoutsoumanou, K.

doi:10.1016/s1474-5151(03)00006-9

Cited by 31 publications

(29 citation statements)

References 28 publications

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“…Community-based CHF management programs involving specialized nurses and multidisciplinary teams have indeed shown to reduce readmission rates and days of hospitalisation and to improve quality of life [128,129]. Nevertheless, intensive home care with nurse-guided intervention to educate for CHF and self-management only led to maintenance of health-related quality of life, but had little effect on self-rated depression scores [130].…”

Section: Family and Social Supportmentioning

confidence: 99%

High impact of depression in heart failure: Early diagnosis and treatment options

Norra¹,

Skobel²,

Arndt³

et al. 2008

International Journal of Cardiology

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Section: Family and Social Supportmentioning

confidence: 99%

High impact of depression in heart failure: Early diagnosis and treatment options

Norra¹,

Skobel²,

Arndt³

et al. 2008

International Journal of Cardiology

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“…There are many incentives for reducing readmission rates from a financial and quality-of-care perspective [6-9]. However, interventions can be time- and cost-intensive [10-14] and it may not be cost-effective to intervene upon every patient regardless of his or her risk of readmission. Traditionally, healthcare providers do a poor job of predicting which patients will be readmitted [15].…”

Section: Introductionmentioning

confidence: 99%

Diagnosis-specific readmission risk prediction using electronic health data: a retrospective cohort study

Hebert

Shivade

Foraker

et al. 2014

BMC Med Inform Decis Mak

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BackgroundReadmissions after hospital discharge are a common occurrence and are costly for both hospitals and patients. Previous attempts to create universal risk prediction models for readmission have not met with success. In this study we leveraged a comprehensive electronic health record to create readmission-risk models that were institution- and patient- specific in an attempt to improve our ability to predict readmission.MethodsThis is a retrospective cohort study performed at a large midwestern tertiary care medical center. All patients with a primary discharge diagnosis of congestive heart failure, acute myocardial infarction or pneumonia over a two-year time period were included in the analysis.The main outcome was 30-day readmission. Demographic, comorbidity, laboratory, and medication data were collected on all patients from a comprehensive information warehouse. Using multivariable analysis with stepwise removal we created three risk disease-specific risk prediction models and a combined model. These models were then validated on separate cohorts.Results3572 patients were included in the derivation cohort. Overall there was a 16.2% readmission rate. The acute myocardial infarction and pneumonia readmission-risk models performed well on a random sample validation cohort (AUC range 0.73 to 0.76) but less well on a historical validation cohort (AUC 0.66 for both). The congestive heart failure model performed poorly on both validation cohorts (AUC 0.63 and 0.64).ConclusionsThe readmission-risk models for acute myocardial infarction and pneumonia validated well on a contemporary cohort, but not as well on a historical cohort, suggesting that models such as these need to be continuously trained and adjusted to respond to local trends. The poor performance of the congestive heart failure model may suggest that for chronic disease conditions social and behavioral variables are of greater importance and improved documentation of these variables within the electronic health record should be encouraged.

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“…Nurse-led heart failure clinics have been shown to be associated with fewer patients with events (death or admission) higher self-care scores [28,29]. Intensive home care of middle-aged patients with severe heart failure has been shown to result in improved quality of life and a decrease in hospital readmission rates [30]. A telephone-mediated nurse care management programme for heart failure has also been shown to reduce the rate of rehospitalization for heart failure, although it has been suggested such programmes may be less effective for patients at low risk compared to higher risk patients [31,32].…”

mentioning

confidence: 99%

Advances in the non-drug, non-surgical, non-device management of chronic heart failure

Coats¹

2005

International Journal of Cardiology

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Effect of Home-Based Intervention on Hospital Readmission and Quality of Life in Middle-Aged Patients with Severe Congestive Heart Failure: A 12-Month Follow Up Study

Abstract: Intensive home care of middle-aged patients with severe heart failure results in improved quality of life and a decrease in hospital readmission rates.

Cited by 31 publications

References 28 publications

High impact of depression in heart failure: Early diagnosis and treatment options

High impact of depression in heart failure: Early diagnosis and treatment options

Diagnosis-specific readmission risk prediction using electronic health data: a retrospective cohort study

Advances in the non-drug, non-surgical, non-device management of chronic heart failure

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