title: Team management of congestive heart failure across the continuum.
abstract: Despite an increased incidence of congestive heart failure and frequency of hospital admissions for the Medicare population, there is little information available on improving outcomes for these patients. As changes in health care lead toward capitation, efficient care with limited use of expensive inpatient hospital resources is a necessity. The coordination of three critical components--inpatient, outpatient, and home care--can lead to positive outcomes in terms of functional capacity changes, length of stay, readmission rates, patient self-care knowledge, and patient satisfaction.
authors.affiliation: Cardiac Rehabilitation Borgess Medical Center Kalamazoo, MI, USA.
authors.forename: G H
authors.initials: GH
authors.lastname: Venner
authors.forename: J S
authors.initials: JS
authors.lastname: Seelbinder
mesh_terms: D000368:Aged; D003266:Continuity of Patient Care / Q000458:organization & administration*; D019091:Critical Pathways / Q000458:organization & administration*; D006333:Heart Failure / Q000451:nursing*; D006699:Home Care Services / Q000458:organization & administration; D006801:Humans; D015146:Midwestern United States; D010348:Patient Care Team / Q000458:organization & administration*; D010353:Patient Education as Topic