Heart Failure Clinics Increase Hospitalizations

Heart failure clinics prevent deaths but patients hospitalized more frequently

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Frequenting specialized heart failure clinics has proved a growing method for receiving care related to heart failure. However, a study has revealed that the outcomes have been mixed.

Though patients receiving care at heart failure clinics are slightly less likely to die within the first few years of being discharged from the clinic, they are at a higher risk of repeat hospitalizations.

"Ask your cardiologist about steps to reduce repeat hospitalization."

Harindra C Wijeysundera, MD, of Sunnybrook Health Sciences at the University of Toronto in Canada, noted that it is unclear whether "efficacy translates to real world effectiveness" when it comes to heart failure clinics.

During the cohort study researchers identified 14,468 heart failure patients, of which 1,288 were seen in one of 34 heart failure clinics classified by an expert panel as low, medium or high intensity. The remainder of patients received the usual standard of care after a heart failure hospitalization.

All of the patients were discharged following a heart failure hospitalization in 2006 or 2007 and followed until March 2010.

After three years of follow up, 52 percent of heart failure clinic patients died compared to 55 percent of standard care patients. Heart failure clinic patients also were significantly more likely to be re-hospitalized for heart failure with 87 percent being readmitted to a hospital during follow up compared to 47 percent in the traditional care group.

About 87 percent of the heart failure clinic group was readmitted to a hospital for any cause versus 59 percent in the other group.

Researchers also found that patients that attended high intensity heart failure clinics were less likely to die, but were more likely to be re-hospitalized for any reason compared to low intensity clinics.

Heart failure clinics were more successful when both the patient and caregiver participated, leading to improved survival as compared to clinics that focused only on patients or emphasized peer support. Clinics that provided frequent contact between providers and heart failure patients had a significant reduction in mortality, while more intensive medication management programs were associated with reduced hospitalization.

The findings were presented Wednesday at the American Heart Association’s Quality of Care and Outcomes Research Scientific Sessions 2012 in Atlanta, Georgia.

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Review Date: 
May 9, 2012
Last Updated:
May 9, 2012