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AHA: Program Cuts Heart Failure Readmits But May Up Mortality

Hospital Readmissions Reduction Program tied to drop in heart failure readmissions at 30 days, 1 year

elderly hospital patient

MONDAY, Nov. 13, 2017 (HealthDay News) -- Implementation of the Hospital Readmissions Reduction Program (HRRP) is associated with a reduction in readmissions for patients with heart failure but also with an increase in mortality, according to a study published online Nov. 12 in JAMA Cardiology to coincide with the American Heart Association's Scientific Sessions, being held Nov. 11 to 15 in Anaheim, California.

Ankur Gupta, M.D., Ph.D., from Harvard Medical School in Boston, and colleagues examined the correlation of the HRRP with readmission and mortality outcomes in patients hospitalized for heart failure. Data were included for 115,245 Medicare beneficiaries across 416 U.S. hospital sites participating in the American Heart Association Get With The Guidelines-Heart Failure (GWTG-HF) registry.

The researchers found that there was a decrease in the 30-day risk-adjusted readmission rate, from 20 percent before HRRP implementation to 18.4 percent in the HRRP penalties phase (hazard ratio, 0.91). In contrast, an increase was seen in the 30-day risk-adjusted mortality rate, from 7.2 percent before HRRP implementation to 8.6 percent in the HRRP penalties phase (hazard ratio, 1.18). A similar pattern was seen for the one-year risk-adjusted readmission and mortality rates, with a decline in the readmission rate from 57.2 to 56.3 percent (hazard ratio, 0.92) and an increase in the mortality rate from 31.3 to 36.3 percent (hazard ratio, 1.1).

"If confirmed, this finding may require reconsideration of the HRRP in heart failure," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry, and the study was partially funded by the GWTG-HF program, which received funding from pharmaceutical and medical device companies.

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