PURPOSE:Heart failure (HF) is a growing public health problem and continues to be a significant cause of hospital admissions. Almost one-third of these patients have class III or IV heart failure, often characterized by progressive deterioration and frequent hospital admissions. These admissions increase overall inpatient costs, especially in patients who have a high degree of chronic functional impairment.Recent studies demonstrate how dedicated service can improve outcomes and quality of life with fewer hospital admissions and lower consumption of resources. Non-cardiology practices report limited incorporation of results from randomized clinical trials. Unfamiliarity with medications and the appropriate doses used to treat heart failure or concern regarding potential side effects may lead to underutilization. There is also marked variation in the management of HF patients. With different organizational patterns, types of patients, and care settings make these management algorithms poorly applicable to most settings, thus influencing outcomes.The objective of this study is to compare the cost and efficiency of a dedicated cardiology service in the management of acute decompensated heart failure.
METHODS:Patient Population: All HF admissions (DRG 127) at Loma Linda University Medical Center in 2005 were included. Admissions were then stratified into Cardiology and non-cardiology (other) service patients. Length of stay (LOS), cost of care, mortality and readmissions were compared.
RESULTS:There were 427 patients admitted with HF in 2005. Of these, 256 (56%) were admitted to Cardiology and 171 (44%) were admitted under non- cardiology (other) service. Cardiology patients have a significant shorter length of stay (3.19 vs. 6.26 days) and have a cost savings of $5,653 per admission.Moreover, there was a significant reduction in hospital mortality rate among patients admitted under in Cardiology.
CONCLUSION:Patients admitted to Cardiology service cost less and have significantly shorter length of stay. There is also a significantly lower mortality rate. Further studies are needed to evaluate this efficiency for application in general medicine service.
CLINICAL IMPLICATIONS:Cost of heart failure hospitalization can significantly be reduced by utilizing a group of dedicated specialist.
DISCLOSURE:Raymond Yau, No Financial Disclosure Information; No Product/Research Disclosure Information