Updates in heart failure 30-day readmission prevention

Heart Fail Rev. 2019 Mar;24(2):177-187. doi: 10.1007/s10741-018-9754-4.

Abstract

Heart failure (HF) and HF 30-day readmission rates have been a major focus of efforts to reduce health care cost in the recent era. Since the implementation of the Affordable Care Act (ACA) in 2012 and the Hospital Readmission Reduction Program (HRRP), concerted efforts have focused on reduction of 30-day HF readmissions and other admission diagnoses targeted by the HRRP. Hospitals and organizations have instituted wide-ranging programs to reduce short-term readmissions, but the data supporting these programs is often mixed. In this review, we will discuss the challenges associated with reducing HF readmissions and summarize the rationale and effect of specific programs on HF 30-day readmission rates, ranging from medical therapy and adherence to remote hemodynamic monitoring. Finally, we will review the effect that the focus on reducing 30-day HF readmissions has had on the care of the HF patient.

Keywords: 30-day readmission reduction; Early follow-up; GDMT; Guideline-directed medical therapy; HRRP; Heart failure; Medication reconciliation and adherence; Remote hemodynamic monitoring; Telemonitoring.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Aftercare / trends
  • Aged
  • Aged, 80 and over
  • Health Care Costs
  • Health Planning Guidelines
  • Heart Failure / economics
  • Heart Failure / epidemiology
  • Heart Failure / therapy*
  • Hemodynamic Monitoring / methods*
  • Hospitals / statistics & numerical data
  • Humans
  • Medication Adherence
  • Monitoring, Physiologic
  • Patient Protection and Affordable Care Act / statistics & numerical data*
  • Patient Readmission / statistics & numerical data*
  • Patient Transfer / methods
  • Prevalence