Specialty Care for Elderly Heart Patients Pays Off

Study finds it improves quality of life while it cuts Medicare costs by 38%

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WEDNESDAY, May 19, 2004 (HealthDayNews) -- Providing specialized nursing care for elderly heart-failure patients while they're in hospital and at home provides those patients with better quality of life and reduces their rates of hospital readmissions.

The University of Pennsylvania study, published in the May issue of the Journal of the American Geriatrics Society, also found specialized care for elderly heart-failure patients resulted in Medicare cost savings of nearly 38 percent.

The study included 239 people 65 years or older with heart failure, all of whom received either routine care or transitional care. In transitional care, a team of doctors, nurses and home-care specialists cares for the patient through the arc of their illness, from admission to hospital to their return to health and home.

Advanced practice nurses visited patients in the transitional care group within 24 hours of their being admitted to hospital. These patients also received a home visit from a nurse within 24 hours of their discharge from the hospital. The patients could also contact the nurses by telephone at any time.

Patients in both groups were followed for a year after hospital discharge.

The study found the cost of providing this transitional care was nearly double the cost of routine care. However, overall, the transitional care saved an average of $4,845 per patient over the follow-up year.

Elderly people with heart failure typically have the highest rate of hospitalization in the United States, with a cost of more than $24 billion a year.

"To date, transitional care programs such as this have typically not been adopted because of lack of Medicare reimbursement, the system's focus on acute versus chronic care, and the organization of care into distinct silos such as hospitals or home care without a safety net to connect them," study author Mary Naylor, a professor of nursing, said in a prepared statement.

As a result of her findings, a major health insurer will conduct a pilot program to test the effectiveness of this kind of transitional care.

More information

The American Heart Association has more about heart failure.

SOURCE: U.S. National Institutes of Health, news release, May 2004

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