Congestive Heart FailureMedical and socioenvironmental predictors of hospital readmission in patients with congestive heart failure☆
Section snippets
Study patients
The study institutions included 5 cardiology units (1 university hospital and 4 nearby hospitals) serving as primary, secondary, and tertiary referral medical centers for cardiovascular patients in Fukuoka, Japan, which has 1.3 million residents. There are several other hospitals with cardiology wards that care for CHF patients, and thus 5 hospitals enrolled in this study did not capture all CHF patients in the study area. The institution medical records identified all patients discharged with
Patient characteristics
Among 3654 patients admitted to 5 participating hospitals during the study period, 263 patients were discharged with a principal diagnosis of CHF. Twenty-six patients (10%) had medical records that did not meet Framingham criteria. Seven patients (2.7%) refused to participate in the study. Thus the remaining 230 patients were included in the current study.
The demographic and clinical characteristics are summarized in Tables II and III, part of which has been reported in our recent study.8Many
Discussion
The major findings of the current study are (1) the readmission rate of patients with CHF is high (35% within 1 year after discharge), (2) patients with a prior history of hospitalization with CHF, hypertension, and longer hospital stay at index admission are at increased risk for readmission, and (3) socioenvironmental factors including poor follow-up and no occupation were also independent predictors associated with CHF readmission. Of the 40 potential predictors, only 5 were found to be
Acknowledgements
Participating investigators constituting the study hospitals are as follows; Samon Koyanagi, MD (National Kyushu Medical Center Hospital); Tetsuji Inou, MD, and Masami Matsuyama, RN (Fukuoka Red Cross Hospital); Yuji Maruoka, MD (Hamanomachi Hospital); Yusuke Yamanoto, MD, and Koji Todaka, MD (Saiseikai Fukuoka General Hospital). This study could not have been carried out without the help, cooperation, and support of the cardiologists in the study hospitals. We also thank the administrators for
References (19)
- et al.
Correlates of early hospital readmission or death in patients with congestive heart failure
Am J Cardiol
(1997) - et al.
Predictors of readmission among elderly survivors of admission with heart failure
Am Heart J
(2000) - et al.
Effect of a multidisciplinary intervention on medication compliance in elderly patients with congestive heart failure
Am J Med
(1996) - et al.
Effects of a multidisciplinary, home-based intervention on unplanned readmissions and survival among patients with chronic congestive heart failure: a randomised controlled study
Lancet
(1999) - et al.
Predicting hospital readmission of elderly cardiac patients
Health Soc Work
(1987) - et al.
Hospital readmissions among the elderly
J Am Geriatr Soc
(1985) - et al.
Effect of DRGs on three-month readmission rate of geriatric patients with congestive heart failure
Am J Public Health
(1988) - et al.
Early readmission of elderly patients with congestive heart failure
J Am Geriatr Soc
(1990) - et al.
Readmission after hospitalization for congestive heart failure among Medicare beneficiaries
Arch Intern Med
(1997)
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Reprint requests: Hiroyuki Tsutsui, MD, PhD, Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 Japan. E-mail: [email protected]