title: Heart Failure Readmission Reduction.
abstract: Little is known regarding effectiveness of readmission reduction programs over time. The Heart Failure Management Program (HFMP) of St. John's Physician Group Practice (PGP) Demonstration provided an opportunity to assess outcomes over an extended period. Data from an electronic health record, an inpatient database, a disease registry, and the Social Security Death Master File were analyzed for patients admitted with heart failure (HF) for 5 years before (Period 1) and 5 years after (Period 2) inception of PGP. HF admissions decreased (Period 1, 58.3/month; Period 2, 52.4/month, P = .007). Thirty-day all-cause readmission rate dropped from Period 1 (annual average 18.8% [668/3545]) to year 1 of Period 2 (16.9% [136/804], P = .04) and remained stable thereafter (annual average 16.8% [589/3503]). Thirty-day mortality rate was flat throughout. HFMP was associated with decreased readmissions, primarily related to outpatient case management, while mortality remained stable.
authors.affiliation: 1 Mercy Health, Chesterfield, MO.
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Drozda
authors.affiliation: 2 Mercy Health, Springfield, MO.
authors.forename: Donna A
authors.initials: DA
authors.lastname: Smith
authors.affiliation: 2 Mercy Health, Springfield, MO.
authors.forename: Paul C
authors.initials: PC
authors.lastname: Freiman
authors.affiliation: 1 Mercy Health, Chesterfield, MO.
authors.forename: Janet
authors.initials: J
authors.lastname: Pursley
authors.affiliation: 3 Centene Corporation, St. Louis, MO.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: VanSlette
authors.affiliation: 1 Mercy Health, Chesterfield, MO.
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Smith
mesh_terms: D000368:Aged; D065187:Controlled Before-After Studies; D005260:Female; D006333:Heart Failure / Q000401:mortality / Q000534:rehabilitation / Q000628:therapy*; D006801:Humans; D008297:Male; D010359:Patient Readmission / Q000706:statistics & numerical data; D015397:Program Evaluation; D058996:Quality Improvement
keywords: accountable care; disease management; heart failure; readmissions