TY - JOUR
T1 - Rehospitalization for heart failure
T2 - Problems and perspectives
AU - Gheorghiade, Mihai
AU - Vaduganathan, Muthiah
AU - Fonarow, Gregg C.
AU - Bonow, Robert O.
N1 - Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2013/1/29
Y1 - 2013/1/29
N2 - With a prevalence of 5.8 million in the United States alone, heart failure (HF) is associated with high morbidity, mortality, and healthcare expenditures. Close to 1 million hospitalizations for heart failure (HHF) occur annually, accounting for over 6.5 million hospital days and a substantial portion of the estimated $37.2 billion that is spent each year on HF in the United States. Although some progress has been made in reducing mortality in patients hospitalized with HF, rates of rehospitalization continue to rise, and approach 30% within 60 to 90 days of discharge. Approximately half of HHF patients have preserved or relatively preserved ejection fraction (EF). Their post-discharge event rate is similar to those with reduced EF. HF readmission is increasingly being used as a quality metric, a basis for hospital reimbursement, and an outcome measure in HF clinical trials. In order to effectively prevent HF readmissions and improve overall outcomes, it is important to have a complete and longitudinal characterization of HHF patients. This paper highlights management strategies that when properly implemented may help reduce HF rehospitalizations and include adopting a mechanistic approach to cardiac abnormalities, treating noncardiac comorbidities, increasing utilization of evidence-based therapies, and improving care transitions, monitoring, and disease management.
AB - With a prevalence of 5.8 million in the United States alone, heart failure (HF) is associated with high morbidity, mortality, and healthcare expenditures. Close to 1 million hospitalizations for heart failure (HHF) occur annually, accounting for over 6.5 million hospital days and a substantial portion of the estimated $37.2 billion that is spent each year on HF in the United States. Although some progress has been made in reducing mortality in patients hospitalized with HF, rates of rehospitalization continue to rise, and approach 30% within 60 to 90 days of discharge. Approximately half of HHF patients have preserved or relatively preserved ejection fraction (EF). Their post-discharge event rate is similar to those with reduced EF. HF readmission is increasingly being used as a quality metric, a basis for hospital reimbursement, and an outcome measure in HF clinical trials. In order to effectively prevent HF readmissions and improve overall outcomes, it is important to have a complete and longitudinal characterization of HHF patients. This paper highlights management strategies that when properly implemented may help reduce HF rehospitalizations and include adopting a mechanistic approach to cardiac abnormalities, treating noncardiac comorbidities, increasing utilization of evidence-based therapies, and improving care transitions, monitoring, and disease management.
KW - heart failure
KW - outcomes
KW - readmission
UR - http://www.scopus.com/inward/record.url?scp=84872678336&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84872678336&partnerID=8YFLogxK
U2 - 10.1016/j.jacc.2012.09.038
DO - 10.1016/j.jacc.2012.09.038
M3 - Review article
C2 - 23219302
AN - SCOPUS:84872678336
SN - 0735-1097
VL - 61
SP - 391
EP - 403
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 4
ER -