Statistical Analysis

Is Inadequate Follow Up Related to Early Hospital Readmissions In Patients with CHF ?

Mudasir Chisti PGYIII Aravind Herle MDRationale & BackgroundHeart Failure is the most common Medicare diagnosis related group .

Patients with CHF are frequently readmitted to the hospital following exacerbation of their symptoms.

The 3-6 month readmission rates have been reported to be as high as 30-50%.Rationale & BackgroundOne-fifth of Medicare beneficiaries are rehospitalized within 30 days.

Nearly 90% of these readmissions are unplanned and potentially preventable.

Translates into $17 billion or nearly 20% of Medicares hospital payments.Medicare contemplates profiling hospitals based on readmision rates with complimentary changes in payment rates.

Hospitals with high risk-adjusted rates of rehospitalization to receive lower average per case payments.

Identifying factors associated with readmissions is therefore important.

Studies suggest that care coordination is important in preventing readmissions.

Early physician follow up post discharge may have potential to reduce readmissions.

Data on follow up patterns following hospitalisation for CHF & its relationship to readmissions is limited.STUDY:Primary Objective: To determine if lack of early Follow Up is associated with 30 Day Readmissions in CHF patients.

Secondary Objectives: To determine readmission rates for CHF.To identify other risk factors for 30 day readmissions.

6Study Design:Case Control Study based on Retrospective Chart review.Single centre based in SBMH.Proper IRB approval obtained for chart review and phone survey5 month period Nov 2010 through March 2011.

Inclusion Criteria :Primary discharge diagnosis of CHF exacerbation on index admission.Cases: CHF patients readmitted within 30 days of discharge for all causes Controls: CHF patients not readmitted within 30 days of discharge.Early Follow Up defined as F/U occuring