Get Your Patients With Heart Failure to Rehab!

Get Your Patients With Heart Failure to Rehab! Posted By:
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Treatment for heart failure (HF) is established, but always growing. The profiles of patients who get HF vary, but one thing that is consistent is that the disease has a profound impact on patients' quality of life, as well as on the healthcare system. Once a patient has had an admission for HF, the ultimate goal is to maintain their health, and most importantly, keep them from being readmitted for the same.

The impact on the healthcare system of readmissions for HF is well established. Since 2014, Medicare has allowed for reimbursement of cardiac rehabilitation services after a hospitalization for HF. Not surprisingly, and quite unfortunately, many individuals do not receive rehab. According to a recent article in the JACC: Heart Failure, over a 2-year span (2014-2016), out of the 11,696 patients involved in 14,258 hospitalizations, only 4.3% of eligible patients took part in cardiac rehab after hospitalization for HF. The authors note several factors for low participation among these Medicare beneficiaries: Some of the factors that indicated less-likely participation in cardiac rehab were Black race; female sex; older age; coming from a non-teaching hospital; having no history of cardiac surgery, cardiac procedures, or cardiac rehabilitation; and having hypertension.

The results of this study should be alarming to all practitioners. Large rates of healthcare disparities still exist, and PAs and NPs must do their best to bridge the gap of this significant problem. If you have eligible patients with HF, do your best to have them seek rehab. This can help to avoid potential problems long-term, and the benefits are plentiful.

References
  • American Heart Association. Review of patients with heart failure who are readmitted. www.heart.org/-/media/files/professional/quality-improvement/target-heart-failure/targethf-readmission-checklist-ucm_496868.pdf?la=en. Accessed July 27, 2021.
  • Bueno H, et al. Trends in length of stay and short-term outcomes among Medicare patients hospitalized for heart failure, 1993-2006. JAMA. 2010;303:2141.
  • Cajita M, et al. Health literacy and heart failure: A systematic review. J Cardiovasc Nurs. 2016;31:121.
  • Joynt K, Jha A. Who has higher readmission rates for heart failure, and why? Implications for efforts to improve care using financial incentives. Circ Cardiovasc Qual Outcomes. 2011;4:53.
  • Ko DT, et al. Readmission and mortality after hospitalization for myocardial infarction and heart failure. JACC. 2020;75:736.
  • Krumholz H, et al. Relationship between hospital readmission and mortality rates for patients hospitalized with acute myocardial infarction, heart failure, or pneumonia. JAMA. 2013;309:587.
  • Pandey A, et al. Temporal trends and factors associated with cardiac rehabilitation participation among Medicare beneficiaries with heart failure. JACC: Heart Failure. 2021;9:471.
  • Yancy CW, et al. 2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure: A report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines and the Heart Failure Society of America. Circulation. 2017;136:e137.

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Filed under: Cardiometabolic

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