Community and Public Health Reducing Hospital Readmissions Among High-Risk Patient Populations
CHF PATIENT
Heart failure (HF) and chronic heart failure (CHF) are among the leading causes of hospitalization and readmission among older adults’ patients, and worldwide. According to the American Heart Association – heart disease and Stroke Statistics Report (2016), the estimated prevalence of HF was 5.7 million, and an estimated 1 million of hospital stay were attributable to CHF.
Heart failure (HF) is one of the leading causes of hospitalization and readmission among older adults. Chronic heart failure (CHF) is the most common cause of readmission among patients in Pakistan and worldwide. Despite this recent attention to HF readmission, we know relatively little about its actual causes even though patients themselves can identify the underlying factors that contribute to their readmissions (Tamakoshi, K, 2021).
Hospital readmissions can negatively impact cost and patient outcomes. Predictors of 30-days readmissions have been primarily identified using medical claims data. Reported here are results of a patient survey developed as part of regular hospital quality assurance activities. Two-thirds of patients reported good discharge experiences but were still readmitted. One-third of patients discharged had a post-discharge doctor appointment scheduled; half were readmitted before that scheduled appointment. Results suggest post-discharge experiences could be improved, especially the timing of follow up doctor appointments. Identified weaknesses in the survey process highlight need for engagement of survey methodologists in efforts to understand patient experiences, good teaching skill, educate patients about medications, how to be compliant with medication instruction, follow up with the next appointment eat , sleep and exercise.( Rigatto, C, 2021).
reduction in early readmission was found to consist of five factors: promoting cognitive functioning and self-care, identifying reasons for readmission, establishing cooperative systems within the community, sharing goals about community life, and creating restful spaces. In hospital nursing care leading to reduction in early readmission was predicted by the following variables: the score on the nursing excellence scale in clinical practice, the score on therapeutic hold, and the participation of community care providers in pre-discharge conferences.
Conclusion: We conclude that, along with patient compliance of medication, appropriate fluid intake, self-care and lifestyle modification, psychotherapies and proper counseling sessions can help reduce the readmissions due to HF. Detailed case records must be maintained by the physicians at the time of diagnosis of such patients.
Reference
Bamforth, R. J., Chhibba, R., Ferguson, T. W., Sabourin, J., Pieroni, D., Askin, N., Tangri, N., Komenda, P., & Rigatto, C. (2021). Strategies to prevent hospital readmission and death in patients with chronic heart failure, chronic obstructive pulmonary disease, and chronic kidney disease: A systematic review and meta-analysis. PLoS ONE, 16(4), 1–26. https://doi.org/10.1371/journal.pone.0249542
Maki, S., Nagai, K., Ando, S., & Tamakoshi, K. (2021). Structure and predictors of in-hospital nursing care leading to reduction in early readmission among patients with schizophrenia in Japan: A cross-sectional study. PLoS ONE, 16(4), 1–20. https://doi.org/10.1371/journal.pone.0250771
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