Heart failure care in the US needs to be improved

Heart failure is a condition wherein the heart gets weakened by disease that it can no longer pump blood effectively. Most often, patients with heart failure have other chronic diseases that include atherosclerosis, arrhythmia, kidney failure, and diabetes.

According to a recent research study, more than half a million Medicare recipients in US older than 65 are hospitalized for heart failure every year. Of these patients, 23% are back at the hospital within 30 days of initial discharge. This rate of rehospitalization is much higher than what is normally observed in other developed countries. It is not clear how this figure compares with rate of hospitalizations among Americans with health insurance coverage.

According to lead author Dr. Joseph S. Ross of Mount Sinai School of Medicine in New York.

“I was hoping for improvement and was disappointed to find that was not the case. Despite the increased focus on the need to reduce readmissions, about a quarter of patients are back into the hospital within 30 days.”

The results of the study indicate a great need for improving health care.

So what are the possible reasons behind this high rate of hospitalization?

• According to the report, the current fee system in the US pays doctors for treating and hospitalizing patients but not for preventive strategies and measures.
• There is a lack of communications between doctors in the hospital and the primary care physicians who help patients manage chronic diseases.

The more specific reasons, however, need to be identified in future studies.

The recommended course of action for hospitals before discharging heart failure patients is that patients should receive written information about the following:

• Eating a proper diet;
• Engaging in appropriate physical activity;
• Taking medicines correctly;
• Monitoring their weight; and
• Knowing what to do if their symptoms worsen.

Previous studies however, have shown that this line of communication between hospitals and primary care clinicians do not work effectively. Efforts are being made to step up with electronic health records which hopefully can overcome this problem.

Dr. Ross continues

“Coming back and forth into the hospital isn’t good for patients, and it isn’t good for the healthcare system. This is a tremendous challenge… Patients should use this information to vet hospitals, to look at the quality of care delivered there and ask questions about the care they receive. Hospitals should consider the rehospitalization rate a grade which, from these findings, needs improvement.”

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