Is there a 'one size fits all' strategy for reducing heart failure readmissions?

摘要

Heart Failure (HF) readmissions have captured national attention since the Center for Medicare and Medicaid Services began public reporting in 2009. Hospitals with the highest readmissions are now receiving substantial penalties and it is estimated that by 2030 HF direct and indirect cost in the US will be 160 billion dollars.1 It is not surprising that an aging population and staggering cost of care have prompt heightened sense of urgency in prevention of admissions and readmissions. We know that some readmissions are preventable and some are unavoidable. A goal should be to identify precipitating factors at the time of admission and develop interventions to address these factors before discharge.The typical HF patient is older, frail, with multiple co morbid conditions, and cognitive impairment. They may receive care from multiple providers in different settings and have limited financial, social, and care giver support. Anticipation of their needs and developing a transition plan that includes community resources may prevent readmission.