title: Benefits of comprehensive inpatient education and discharge planning combined with outpatient support in elderly patients with congestive heart failure.
abstract: Multidisciplinary disease management programs for congestive heart failure have been shown to substantially reduce readmission rates, resulting in a reduction of costs. These interventions, however, have typically included changes in medical management, making it difficult to quantitate the key elements of a successful program involving education, discharge planning, and transitional care in the outpatient setting. The investigators utilized an experienced cardiac nurse educator to coordinate a targeted inpatient congestive heart failure education program coupled with comprehensive discharge planning and immediate outpatient reinforcement through a coordinated nurse-driven home health care program. The comprehensive intervention resulted in a marked reduction in 6-month readmission rates, from 44.2% to 11.4% (p=0.01). The average total cost saving for each subject in the interventional group was $1541, based on the decreased utilization of both skilled nursing services and home health care during outpatient follow-up. The costs to implement an inpatient education program were negligible, at $158 per subject. There was no difference in discharge medications or medical management protocols that would have influenced these results.
authors.affiliation: Department of Medicine, Division of Cardiovascular Medicine, Bridgeport Hospital, Bridgeport, CT 06610, USA.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Anderson
authors.forename: B V
authors.initials: BV
authors.lastname: Deepak
authors.forename: Yaw
authors.initials: Y
authors.lastname: Amoateng-Adjepong
authors.forename: Stuart
authors.initials: S
authors.lastname: Zarich
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003237:Connecticut; D003266:Continuity of Patient Care / Q000191:economics*; D017046:Cost Savings; D019468:Disease Management; D015577:Geriatric Assessment; D006333:Heart Failure / Q000175:diagnosis / Q000191:economics / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D010351:Patient Discharge / Q000191:economics* / Q000592:standards; D010353:Patient Education as Topic / Q000458:organization & administration*; D011336:Probability; D016730:Program Development; D015397:Program Evaluation; D012016:Reference Values; D012657:Self-Help Groups