Specialty-related disparities of readmission in patients with chronic heart failure: the importance of hospital-clinic cooperation.
OBJECTIVE
The purpose of this study was to elucidate differences in readmission rates and late outcome in outpatients with chronic heart failure treated in different clinical settings.


METHODS
This study included 65 consecutive patients who were admitted to our CCU due to acute heart failure for the first time and discharged from our institution. After their discharge, 31 were cared for by a cardiologist in the outpatient clinic of our institution (group A) and the other 34 were cared for by a general practitioner in a clinic (group B). The various findings during the acute phase and the follow-up period were retrospectively compared between the two groups. In addition, the incidence of unexpected readmission and prolonged outcomes were compared between the two groups.


RESULTS
The patients in group B were older than those in group A, but no other differences were noted in patient characteristics. More patients in group A required more than one hospitalization within 6 months from discharge (group A, 35.5%; group B, 8.9%, p<0.01; follow-up period, 17.1+/-5.9 months). There was no difference in the survival rate between the groups.


CONCLUSIONS
We concluded that stabilized outpatients should receive comprehensive care from a general practitioner to avoid the need for readmission after discharge.
Sakakibara
M
M
Second Department of Internal Medicine, St. Marianna University of Medicine, Kanagawa.
Kongoji
K
K
Samejima
H
H
Shiota
K
K
Takagi
A
A
Miyake
F
F
Murayama
M
M
D000368:Aged; D002908:Chronic Disease; D003325:Coronary Care Units; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D008511:Medicine / Q000706:statistics & numerical data*; D010044:Outpatient Clinics, Hospital; D010351:Patient Discharge / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013038:Specialization; D015996:Survival Rate; D016896:Treatment Outcome