Evaluation of a Community Health Service Center-Based Intervention Program for Managing Chronic Heart Failure

Gu, Moli; Zhou, Ti; Xia, Yunfeng

doi:10.5152/balkanmedj.2015.150023

Cited by 6 publications

(7 citation statements)

References 28 publications

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“…According to the population sampled in this study, cardiologists are the main physician speciality involved in first consultations of patients with a suspicion of HF, as well as in confirming HF diagnoses and initiating treatment; there is little involvement of family physicians, with only 10% being responsible for a first consultation and even fewer involved in diagnosis and treatment. These findings reflect the fact that involvement of primary care in HF management programs in China is extremely limited 19 and differ from studies of HF care pathways in Western countries, 7 , 8 where the family physician acts as a primary contact for patients with HF and will refer patients to specialists for further input when needed. Shared decision making is important for patient-centered care, whereby the physician educates the patient about treatment options, possible outcomes, and side effects, in order to reach an informed treatment decision.…”

Section: Discussionmentioning

confidence: 62%

Care pathways and treatment patterns for patients with heart failure in China: results from a cross-sectional survey

Jackson

Cotton

Wirta

et al. 2018

DDDT

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PurposeThe objective of this study was to describe the clinical care pathways, management and treatment patterns, and hospitalizations for patients with heart failure (HF) in China.Subjects and methodsA cross-sectional survey of cardiologists and their patients with HF was conducted. Patient record forms were completed by 150 cardiologists for 10 consecutive patients. Patients for whom a patient record form was completed were invited to complete a patient self-completion questionnaire.ResultsMost of the 1,500 patients (mean [SD] age 66 [10] years; 55% male) included in the study received care in tier-2 and -3 hospitals in large cities. Cardiologists were responsible for initial consultation, diagnosis, and treatment of patients with HF. The use of guideline-recommended diagnostics was high. However, guideline-recommended double- and triple-combination therapy was received by only 51% and 18% of patients, respectively. In total, 20% of patients with HF reported that they were not consulted on the choice of therapy. Concordance was high (≥80%) between matched cardiologist and patient pairs for the occurrence of side effects, while cardiologists more often under- than overreported the occurrence of side effects of treatment reported by patients.ConclusionThe management of HF was predominantly overseen by cardiologists. The use of diagnostic tests was high, but the use of guideline-recommended treatment was low in this population. Improved communication between patients and cardiologists is essential to optimize treatment decision making and to increase awareness of treatment side effects.

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Section: Discussionmentioning

confidence: 62%

Care pathways and treatment patterns for patients with heart failure in China: results from a cross-sectional survey

Jackson

Cotton

Wirta

et al. 2018

DDDT

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“…41 The implementation of various heart failure intervention programs has been shown to reduce hospitalizations and improve outcomes. 42,43 However, our findings suggest the need for the development of interventions that target underlying comorbidities, particularly heart failure, in earlier CKD risk patients before the onset of dialysis treatment. This strategy could improve patient outcomes and reduce potentially preventable hospitalization costs.…”

Section: Discussionmentioning

confidence: 87%

Cost of Potentially Preventable Hospitalizations Among Adults With Chronic Kidney Disease: A Population-Based Cohort Study

Chong

Wick

Klarenbach

et al. 2021

Can J Kidney Health Dis

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Background: Prior studies report high hospitalization rates among patients with chronic kidney disease (CKD) and approximately 10% to 20.9% of hospitalizations are potentially preventable. Objective: To determine the rate, proportion, and cost of potentially preventable hospitalizations and whether this varied by CKD category. Design: Retrospective cohort study using population-based data. Setting: Alberta, Canada. Patients: All adults with an outpatient serum creatinine measurement between January 1 and December 31, 2017 in the Alberta Kidney Disease Network data repository. Measurements: CKD risk categories were based on measures of proteinuria (where available), eGFR, and use of dialysis. Patients were linked to administrative data to capture frequency and cost of hospital encounters and followed until death or end of study (December 31, 2018). The outcomes of interest were the rate and cost of potentially preventable hospitalizations, as identified using the Canadian Institute for Health Information (CIHI)-defined ambulatory care sensitive condition (ACSC) algorithm and a CKD-related ACSC algorithm. Methods: Unadjusted and adjusted rates per 1000-patient years, proportions, and cost attributable to preventable hospitalizations were identified for the cohort as a whole and for patients within each CKD risk category. Results: Of the 1,110,895 adults with eGFR and proteinuria measurements, 181,422 had CKD. During a median follow-up of 1 year, there were 62,023 hospitalizations among patients with CKD resulting in a total cost of $946 million CAD; 6907 (11.1%) of these hospitalizations were for CIHI-defined ACSCs while 4323 (7.0%) were for CKD-related ACSCs. Adjusted rates of hospitalization for ACSCs increased with CKD risk category and were highest among patients treated with dialysis. Among CKD patients, the total cost of potentially preventable hospitalizations was $79 million and $58 million CAD for CIHI-defined and CKD-related ACSCs (8.4% and 6.2% of total hospitalization cost, respectively). Limitations: Based on the ACSC construct, we were unable to determine if these hospitalizations were truly preventable. Conclusions: Potentially preventable hospitalizations have a substantial cost and burden on the health care system among people with CKD. Effective strategies that reduce preventable admissions among CKD patients may lead to significant cost savings. Trial registration: Not applicable—observational study design

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“…Among the 10 articles accepted, two articles were intervention studies (randomized controlled trials/RCT) (Luger et al, 2016;Mirmolaei et al, 2014), two articles were cross-sectional studies (Flores-Quispe et al, 2022;Nsibande et al, 2013), three articles were cohort studies (retrospective cohort dan population-based retrospective cohort) (Gu et al, 2016;Jones et al, 2020;Misra-Hebert et al, 2021) and three articles were qualitative studies (Campos et al, 2014;Kari et al, 2022;Silverman et al, 2018). In the RCT targeting postpartum mothers, the intervention group received health care through home visits by midwives, while the control group was only given services at health facilities (Mirmolaei et al, 2014).…”

Section: Resultsmentioning

confidence: 99%

“…Various countries implement varying home visits' scope of services and providers. The scope of services in this review is categorized based on the life cycle, specifically maternal and child health (Flores-Quispe et al, 2022;Mirmolaei et al, 2014;Nsibande et al, 2013), productive age and the elderly (Gu et al, 2016;Jones et al, 2020;Kari et al, 2022;Luger et al, 2016;Misra-Hebert et al, 2021;Silverman et al, 2018), and life-cycle approach (Campos et al, 2014). The home visits are mostly conducted by community health workers and nurses, followed by doctors, midwives, and multidisciplinary teams.…”

Section: Home Visits' Scope Of Services and Providersmentioning

confidence: 99%

Untitled

Putri¹,

Ayuningtyas²

2023

JKM

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Health Care (PHC) is a foundation of universal health coverage for enabling equitable access. However, the access barrier is one of the challenges in implementing PHC. Home visits becomes one of the PHC innovations in several countries. This review aimed to describe home visit implementation in various countries regarding the scope, and service providers to achieve the expected impacts. This descriptive study used scoping review method referring to Arksey and O'Malley's guidelines. Three databases, which are PubMed, ProQuest, and Embase, were searched using keywords, namely "home visit" and "primary health care" or "primary healthcare" or "PHC services". The articles' identification used the PRISMA method. From the search result that was limited to 2002-2022, 367 articles were retrieved and screened for titles and abstracts, resulting in 48 full-text articles for eligibility assessment. Finally, ten studies were further analyzed and synthesized according to the study's aim. The scope of home visits is a comprehensive life cycle approach. Services providers are community health workers, nurses, midwives, doctors, and multidisciplinary teams. The impact of home visits is increasing knowledge and healthy behaviour, utilization, service quality, and health status as well as encouraging cross-sectoral collaboration and interprofessional collaboration. The scope and the impact of the home visit were then categorized based on the three PHC components according to WHO. This research result can be used as input in the development of evidence-based policies for the implementation of home visits as part of the services provided by first-level health facilities with adjustments to the context in Indonesia.

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Evaluation of a Community Health Service Center-Based Intervention Program for Managing Chronic Heart Failure

Cited by 6 publications

References 28 publications

Care pathways and treatment patterns for patients with heart failure in China: results from a cross-sectional survey

Care pathways and treatment patterns for patients with heart failure in China: results from a cross-sectional survey

Cost of Potentially Preventable Hospitalizations Among Adults With Chronic Kidney Disease: A Population-Based Cohort Study

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