Assessment of Time to Hospital Encounter after an Initial Hospitalization for Heart Failure: Results from a Tertiary Medical Center
Background. Hospital inpatient readmissions for patients admitted initially with the primary diagnosis of heart failure (HF) can be as high as 20–25% within 30 days of discharge. This, however, does not include admissions for observations or emergency department (ED) visits within the same time fram...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Cardiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2018/6087367 |
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| _version_ | 1832567611170226176 |
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| author | Nicolas W. Shammas Ryan Kelly Jon Lemke Ram Niwas Sarah Castro Christine Beuthin Jackie Carlson Marti Cox Gail A. Shammas Terri DeClerck Kathy Lenaghan Sunny Arikat Marcia Erickson |
| author_facet | Nicolas W. Shammas Ryan Kelly Jon Lemke Ram Niwas Sarah Castro Christine Beuthin Jackie Carlson Marti Cox Gail A. Shammas Terri DeClerck Kathy Lenaghan Sunny Arikat Marcia Erickson |
| author_sort | Nicolas W. Shammas |
| collection | DOAJ |
| description | Background. Hospital inpatient readmissions for patients admitted initially with the primary diagnosis of heart failure (HF) can be as high as 20–25% within 30 days of discharge. This, however, does not include admissions for observations or emergency department (ED) visits within the same time frame and does not show a time-dependent hospital encounter following discharge after an index admission. We present data on time-dependent hospital encounter of HF patients discharged after an index admission for a primary diagnosis of HF. Methods. The study recruited patients from 2 hospitals within the same health system. 500 consecutive admissions with the ICD diagnosis of HF were reviewed by inclusion and exclusion screening criteria. The 166 eligible remaining patients were tracked for post hospital discharge encounters consisting of hospital admissions, observation stays, and ED visits. Only those with a primary diagnosis of heart failure were included. Demographics were recorded on all patients. Days until hospital inpatient readmissions or hospital encounters were displayed in Kaplan–Meier plots. Results. A total of 166 patients met inclusion criteria (mean age 79.3 years, males 54%). For the first 90 days following the index admission, there were a total of 287 follow-up visits (1.7 per patient), 1158 total hospitalization days (2.6 per visit, 7.0 per patient, and 8.6 per 100 days at risk), and 21 deaths (12.7%). At 30 days, 25% and 52% of patients had an inpatient readmission or a hospital encounter, respectively. The median time to inpatient readmission was 117 days and to hospital encounter was 27 days. Conclusion. Time-dependent excess days in acute care (unplanned inpatient admission, outpatient observation, and ED visit) rather than 30-day hospital inpatient readmission rate is a more realistic measure of the intensity of care required for HF patients after index admission. |
| format | Article |
| id | doaj-art-b4753fb806044f4d873cedff8adff5f8 |
| institution | Kabale University |
| issn | 2090-8016 2090-0597 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cardiology Research and Practice |
| spelling | doaj-art-b4753fb806044f4d873cedff8adff5f82025-02-03T01:00:59ZengWileyCardiology Research and Practice2090-80162090-05972018-01-01201810.1155/2018/60873676087367Assessment of Time to Hospital Encounter after an Initial Hospitalization for Heart Failure: Results from a Tertiary Medical CenterNicolas W. Shammas0Ryan Kelly1Jon Lemke2Ram Niwas3Sarah Castro4Christine Beuthin5Jackie Carlson6Marti Cox7Gail A. Shammas8Terri DeClerck9Kathy Lenaghan10Sunny Arikat11Marcia Erickson12Genesis Health System, Davenport, IA, USAGenesis Health System, Davenport, IA, USAGenesis Health System, Davenport, IA, USAGenesis Health System, Davenport, IA, USAGenesis Health System, Davenport, IA, USAGenesis Health System, Davenport, IA, USAGenesis Health System, Davenport, IA, USAGenesis Health System, Davenport, IA, USAMidwest Cardiovascular Research Foundation, Davenport, IA, USAGenesis Health System, Davenport, IA, USAGenesis Health System, Davenport, IA, USAGenesis Health System, Davenport, IA, USAGenesis Health System, Davenport, IA, USABackground. Hospital inpatient readmissions for patients admitted initially with the primary diagnosis of heart failure (HF) can be as high as 20–25% within 30 days of discharge. This, however, does not include admissions for observations or emergency department (ED) visits within the same time frame and does not show a time-dependent hospital encounter following discharge after an index admission. We present data on time-dependent hospital encounter of HF patients discharged after an index admission for a primary diagnosis of HF. Methods. The study recruited patients from 2 hospitals within the same health system. 500 consecutive admissions with the ICD diagnosis of HF were reviewed by inclusion and exclusion screening criteria. The 166 eligible remaining patients were tracked for post hospital discharge encounters consisting of hospital admissions, observation stays, and ED visits. Only those with a primary diagnosis of heart failure were included. Demographics were recorded on all patients. Days until hospital inpatient readmissions or hospital encounters were displayed in Kaplan–Meier plots. Results. A total of 166 patients met inclusion criteria (mean age 79.3 years, males 54%). For the first 90 days following the index admission, there were a total of 287 follow-up visits (1.7 per patient), 1158 total hospitalization days (2.6 per visit, 7.0 per patient, and 8.6 per 100 days at risk), and 21 deaths (12.7%). At 30 days, 25% and 52% of patients had an inpatient readmission or a hospital encounter, respectively. The median time to inpatient readmission was 117 days and to hospital encounter was 27 days. Conclusion. Time-dependent excess days in acute care (unplanned inpatient admission, outpatient observation, and ED visit) rather than 30-day hospital inpatient readmission rate is a more realistic measure of the intensity of care required for HF patients after index admission.http://dx.doi.org/10.1155/2018/6087367 |
| spellingShingle | Nicolas W. Shammas Ryan Kelly Jon Lemke Ram Niwas Sarah Castro Christine Beuthin Jackie Carlson Marti Cox Gail A. Shammas Terri DeClerck Kathy Lenaghan Sunny Arikat Marcia Erickson Assessment of Time to Hospital Encounter after an Initial Hospitalization for Heart Failure: Results from a Tertiary Medical Center Cardiology Research and Practice |
| title | Assessment of Time to Hospital Encounter after an Initial Hospitalization for Heart Failure: Results from a Tertiary Medical Center |
| title_full | Assessment of Time to Hospital Encounter after an Initial Hospitalization for Heart Failure: Results from a Tertiary Medical Center |
| title_fullStr | Assessment of Time to Hospital Encounter after an Initial Hospitalization for Heart Failure: Results from a Tertiary Medical Center |
| title_full_unstemmed | Assessment of Time to Hospital Encounter after an Initial Hospitalization for Heart Failure: Results from a Tertiary Medical Center |
| title_short | Assessment of Time to Hospital Encounter after an Initial Hospitalization for Heart Failure: Results from a Tertiary Medical Center |
| title_sort | assessment of time to hospital encounter after an initial hospitalization for heart failure results from a tertiary medical center |
| url | http://dx.doi.org/10.1155/2018/6087367 |
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