The Prevention of Hospital Readmissions in Heart Failure.

Heart failure (HF) is a growing healthcare burden and one of the leading causes of hospitalizations and readmission. Preventing readmissions for HF patients is an increasing priority for clinicians, researchers, and various stakeholders. The following review will discuss the interventions found to reduce readmissions for patients and improve hospital performance on the 30-day readmission process measure. While evidence-based therapies for HF management have proliferated, the consistent implementation of these therapies and development of new strategies to more effectively prevent readmissions remain areas for continued improvement.

[1]  C. Yancy,et al.  Relationship between early physician follow-up and 30-day readmission among Medicare beneficiaries hospitalized for heart failure. , 2010, JAMA.

[2]  J. Fleg,et al.  Digoxin use and lower 30-day all-cause readmission for Medicare beneficiaries hospitalized for heart failure. , 2014, The American journal of medicine.

[3]  J. McMurray,et al.  Eplerenone in patients with systolic heart failure and mild symptoms. , 2011, The New England journal of medicine.

[4]  B. Pitt,et al.  The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. , 1999, The New England journal of medicine.

[5]  Leora I. Horwitz,et al.  Medication Reconciliation Accuracy and Patient Understanding of Intended Medication Changes on Hospital Discharge , 2012, Journal of General Internal Medicine.

[6]  Steven H. Landers,et al.  Mini-cog performance: novel marker of post discharge risk among patients hospitalized for heart failure. , 2014, Circulation. Heart failure.

[7]  B. Pitt,et al.  The Effect of Spironolactone on Morbidity and Mortality in Patients with Severe Heart Failure , 2000 .

[8]  J. McMurray,et al.  Eplerenone in Patients With Systolic Heart Failure and Mild Symptoms: Analysis of Repeat Hospitalizations , 2012, Circulation.

[9]  M. Borggrefe,et al.  Intrathoracic Impedance Monitoring, Audible Patient Alerts, and Outcome in Patients With Heart Failure , 2011, Circulation.

[10]  Laura G. Qualls,et al.  Comparative Effectiveness of Cardiac Resynchronization Therapy With an Implantable Cardioverter-Defibrillator Versus Defibrillator Therapy Alone , 2014, Annals of Internal Medicine.

[11]  B. Waterman,et al.  Adding socioeconomic data to hospital readmissions calculations may produce more useful results. , 2014, Health affairs.

[12]  Melissa M Deer,et al.  Open-label randomized trial of torsemide compared with furosemide therapy for patients with heart failure. , 2001, The American journal of medicine.

[13]  Leora I. Horwitz,et al.  Association of Discharge Summary Quality With Readmission Risk for Patients Hospitalized With Heart Failure Exacerbation , 2015, Circulation. Cardiovascular quality and outcomes.

[14]  A. Jha,et al.  Who Has Higher Readmission Rates for Heart Failure, and Why?: Implications for Efforts to Improve Care Using Financial Incentives , 2011, Circulation. Cardiovascular quality and outcomes.

[15]  Akshay S. Desai,et al.  Angiotensin-neprilysin inhibition versus enalapril in heart failure. , 2014, The New England journal of medicine.

[16]  Harlan M Krumholz,et al.  Trajectories of risk after hospitalization for heart failure, acute myocardial infarction, or pneumonia: retrospective cohort study , 2015, BMJ : British Medical Journal.

[17]  Amanda H. Salanitro,et al.  Risk prediction models for hospital readmission: a systematic review. , 2011, JAMA.

[18]  T. Therneau,et al.  Hospitalizations after heart failure diagnosis a community perspective. , 2009, Journal of the American College of Cardiology.

[19]  D. Mozaffarian,et al.  Heart disease and stroke statistics--2014 update: a report from the American Heart Association. , 2014, Circulation.

[20]  P. Austin,et al.  Outcomes in patients with heart failure treated in hospitals with varying admission rates: population-based cohort study , 2014, BMJ quality & safety.

[21]  A. Jha,et al.  A path forward on Medicare readmissions. , 2013, The New England journal of medicine.

[22]  S. Normand,et al.  Trends in length of stay and short-term outcomes among Medicare patients hospitalized for heart failure, 1993-2006. , 2010, JAMA.

[23]  M. Vaduganathan,et al.  Drug therapy to reduce early readmission risk in heart failure: ready for prime time? , 2013, JACC. Heart failure.

[24]  Carol R Horowitz,et al.  Effects of Nurse Management on the Quality of Heart Failure Care in Minority Communities , 2006, Annals of Internal Medicine.

[25]  E John Orav,et al.  The relationship between hospital admission rates and rehospitalizations. , 2011, The New England journal of medicine.

[26]  L. Stevenson,et al.  Wireless pulmonary artery haemodynamic monitoring in chronic heart failure: a randomised controlled trial , 2011, The Lancet.

[27]  S. Najjar,et al.  Hospital readmission in heart failure, a novel analysis of a longstanding problem , 2015, Heart Failure Reviews.

[28]  R. Bhalla,et al.  Could Medicare Readmission Policy Exacerbate Health Care System Inequity? , 2010, Annals of Internal Medicine.

[29]  J. Cohn,et al.  The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. U.S. Carvedilol Heart Failure Study Group. , 1996, The New England journal of medicine.

[30]  Mark V. Williams,et al.  Interventions to Reduce 30-Day Rehospitalization: A Systematic Review , 2011, Annals of Internal Medicine.

[31]  A. Jha,et al.  The Association Between Hospital Volume and Processes, Outcomes, and Costs of Care for Congestive Heart Failure , 2011, Annals of Internal Medicine.

[32]  Graham Ingalsbe,et al.  Neighborhood Socioeconomic Disadvantage and 30-Day Rehospitalization , 2015 .

[33]  E. J. Brown,et al.  The effect of digoxin on mortality and morbidity in patients with heart failure. , 1997, The New England journal of medicine.

[34]  Leora I. Horwitz,et al.  Diagnoses and timing of 30-day readmissions after hospitalization for heart failure, acute myocardial infarction, or pneumonia. , 2013, JAMA.

[35]  G. Fonarow,et al.  Clinical effectiveness of beta-blockers in heart failure: findings from the OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure) Registry. , 2009, Journal of the American College of Cardiology.

[36]  V. Hasselblad,et al.  Predischarge initiation of carvedilol in patients hospitalized for decompensated heart failure: results of the Initiation Management Predischarge: Process for Assessment of Carvedilol Therapy in Heart Failure (IMPACT-HF) trial. , 2004, Journal of the American College of Cardiology.

[37]  Haya R Rubin,et al.  Comprehensive discharge planning with postdischarge support for older patients with congestive heart failure: a meta-analysis. , 2004, JAMA.

[38]  D. Nerenz,et al.  Socioeconomic status and readmissions: evidence from an urban teaching hospital. , 2014, Health affairs.

[39]  S. Schneeweiss,et al.  Repeated hospitalizations predict mortality in the community population with heart failure. , 2007, American heart journal.

[40]  Robert A Berenson,et al.  Medicare's readmissions-reduction program--a positive alternative. , 2012, The New England journal of medicine.

[41]  Laura G. Qualls,et al.  Associations between aldosterone antagonist therapy and risks of mortality and readmission among patients with heart failure and reduced ejection fraction. , 2012, JAMA.

[42]  Maulik S Joshi,et al.  Community factors and hospital readmission rates. , 2015, Health services research.

[43]  H. Krumholz,et al.  Telemonitoring in patients with heart failure. , 2010, The New England journal of medicine.

[44]  K. Swedberg,et al.  Clinical course and predictive value of congestion during hospitalization in patients admitted for worsening signs and symptoms of heart failure with reduced ejection fraction: findings from the EVEREST trial. , 2013, European heart journal.

[45]  Harlan M Krumholz,et al.  Relationship between hospital readmission and mortality rates for patients hospitalized with acute myocardial infarction, heart failure, or pneumonia. , 2013, JAMA.

[46]  Dylan S. Small,et al.  Hospitals with higher nurse staffing had lower odds of readmissions penalties than hospitals with lower staffing. , 2013, Health affairs.

[47]  Robert O. Bonow,et al.  Rehospitalization for heart failure: problems and perspectives. , 2013, Journal of the American College of Cardiology.

[48]  R. Carney,et al.  A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failure. , 1995, The New England journal of medicine.

[49]  Carl van Walraven,et al.  A meta-analysis of hospital 30-day avoidable readmission rates. , 2012, Journal of evaluation in clinical practice.

[50]  Harlan M. Krumholz,et al.  Hospital Strategies Associated With 30-Day Readmission Rates for Patients With Heart Failure , 2013, Circulation. Cardiovascular quality and outcomes.

[51]  J. Daubert,et al.  The effect of cardiac resynchronization on morbidity and mortality in heart failure. , 2005, The New England journal of medicine.

[52]  Mark D. Huffman,et al.  AHA Statistical Update Heart Disease and Stroke Statistics — 2012 Update A Report From the American Heart Association WRITING GROUP MEMBERS , 2010 .

[53]  Harlan M Krumholz,et al.  Randomized trial of an education and support intervention to prevent readmission of patients with heart failure. , 2002, Journal of the American College of Cardiology.

[54]  Nancy M Albert,et al.  Association between performance measures and clinical outcomes for patients hospitalized with heart failure. , 2007, JAMA.

[55]  Steven H. Landers,et al.  Mini-Cog PerformanceCLINICAL PERSPECTIVE , 2015 .