CAN WE PREVENT HEART FAILURE READMISSIONS?


Paul A. Heidenreich, M.D., Stanford University, Palo Alto, CA, USA

Readmissions are common following an admission for heart failure occurring in 20-30% of patients within 30 days of discharge. Many payers including U.S. Medicare have estimated that a large fraction of these readmissions are preventable (up to 75%). Accordingly, the U.S. Medicare program has instituted financial penalties for hospitals with higher than average readmission rates. In response, hospitals are now keenly interested in interventions to reduce 30 day readmissions for patients with heart failure. The presentation will review published reports on the fraction of readmissions that are deemed preventable and randomized trial data of interventions designed to reduce readmissions. In addition the presentation will include a new analysis (unpublished) of US Veterans Affairs Hospital data on the readmission impact of the Hospital to Home (H2H) Initiative of the American College of Cardiology and Institute for Health Care Improvement. Our findings suggest that while interventions such as the Hospital to Home may be effective their impact is long-term and not easily measured at 30 days.