Cut Heart Failure Readmissions by 25% with In-Home Care
Executive Brief
- The News: 25% of Medicare beneficiaries are readmitted within 30 days of discharge for heart failure
- Clinical Win: Women in MIH group are 30% less likely to be readmitted to hospital
- Target Specialty: Cardiologists managing female heart failure patients under 70
Key Data at a Glance
Readmission Rate: 20%
Sample Size: over 2,000 patients
Reduction in Readmission for Women: 30%
Reduction in Heart Failure Admission for Women: 36%
Age Group with Better Health Status: younger than 70
Follow-up Period: 30 days
Cut Heart Failure Readmissions by 25% with In-Home Care
Mobile integrated health (MIH) can help heart failure patients transition from the hospital to home, and may offer additional benefits to women and younger patients, say Columbia Nursing researchers in a report in JAMA Internal Medicine.
Heart failure is the number one cause of hospitalization for older adults in the U.S., and up to 25% of Medicare beneficiaries hospitalized for heart failure are readmitted within 30 days of discharge. Professor Ruth Masterson Creber, Ph.D., director of the Center for Community-Engaged Informatics and Data Science, and her colleagues note that MIH and a transitions of care coordinator (TOCC) have both shown promise in improving outcomes for these patients, but their effectiveness has not been compared.
In the Mighty-Heart trial, Professor Masterson Creber and her colleagues randomly assigned more than 2,000 patients hospitalized for heart failure from 11 New York City hospitals to either TOCC (a follow-up call from a nurse within 48–72 hours of discharge) or TOCC plus MIH (additional nurse care coordination, community paramedic home visits, and telehealth with emergency medicine physicians).
At 30 days after discharge, 20% of patients in each group had been readmitted to the hospital, and there was no significant difference between the two groups in health status or health care utilization. However, MIH was associated with better health status among patients younger than 70. Women in the MIH group were 30% less likely to be readmitted to the hospital for any cause and 36% less likely to be admitted for heart failure compared to the TOCC only group.
Clinical Perspective — Dr. Deepak Nair, Rheumatology
Workflow: I now consider mobile integrated health (MIH) for heart failure patients, especially after learning that it involves additional nurse care coordination, community paramedic home visits, and telehealth with emergency medicine physicians. This changes my daily routine as I'd discuss MIH with patients before discharge, particularly for those younger than 70. The Mighty-Heart trial's use of a transitions of care coordinator (TOCC) and MIH informs my post-discharge planning.
Economics: The article doesn't address cost directly, but the reduction in hospital readmissions could lead to significant cost savings. For instance, if we see a similar 30% reduction in readmissions among women in our patient population, it could have a substantial impact on healthcare utilization costs. However, more data is needed to fully understand the economic benefits of MIH.
Patient Outcomes: I'm impressed by the 30% and 36% reductions in hospital readmissions for any cause and heart failure, respectively, among women in the MIH group. This tangible patient benefit informs my decision to consider MIH, especially for younger women with heart failure. The fact that MIH was associated with better health status among patients younger than 70 also guides my treatment approach for this patient subgroup.
Transparency & Corrections
HCP Connect is funded by Stravent LLC and maintains editorial independence from advertisers and pharmaceutical companies. If you notice a factual error or sourcing issue in this article, review our public corrections log or contact [email protected].