Early follow-up care boosts outcomes, including survival, among heart failure patients

Early physician visits after hospital discharge are associated with better outcomes for heart failure patients, according to new research published in JAMA Network Open.[1]

“The days immediately after hospital discharge are a period of increased risk for patients,” wrote first author Farah E. Saxena, MPH, from the Canadian Partnership Against Cancer, and colleagues. “Because of stressors and deconditioning occurring during hospitalization and lingering illness effects, optimal transitions between hospital and ambulatory sectors are key to improving health and reducing readmissions.”

Saxena et al. explored ICES data from more than 450,000 patients who were hospitalized from 2005 to 2019. This included more than 198,000 acute myocardial infarction (AMI) patients, more than 133,000 congestive heart failure (CHF) patients and more than 118,000 chronic obstructive pulmonary disorder (COPD).

The researchers found that 46% of AMI patients, 42% of CHF patients and 34% of COPD patients saw a primary care physician, cardiologist or other relevant provider within seven days of being discharged from the hospital. These were what the group considered to be early follow-up visits.

Overall, early follow-up visits were linked to lower 90-day readmission rates among CHF patients (28.2% vs. 30.2%) and COPD patients (21.8% vs. 23%), but there was no significant different among AMI patients. Early follow-up care also improved 90-day mortality for CHF patients (7.2% vs. 8.2%).

“These findings may have implications for performance measurement and practice improvement,” the authors wrote. “Early postdischarge physician visits may be important to maximize the reduction in adverse events associated with treatment for patients with medically complex conditions.”

They also noted that follow-up care for these patient populations has been stagnant in recent years.

“Early physician follow-up and readmission rates did not change in 15 years, despite performance measurement and reporting, suggesting the need to better develop, implement, and evaluate comprehensive models of care that address factors associated with readmission, along with implementation strategies associated with improvement,” the authors concluded.

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1. Farah E. Saxena, MPH; Arlene S. Bierman, MD, MS; Richard H. Glazier, MD, MPH, et al. Association of Early Physician Follow-up With Readmission Among Patients Hospitalized for Acute Myocardial Infarction, Congestive Heart Failure, or Chronic Obstructive Pulmonary Disease. JAMA Netw Open. 2022;5(7):e2222056.

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