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May 2017

Reconfiguring the Hospital-to-Home Transition Into an Active Treatment Period for Patients With Heart Failure

Author Affiliations
  • 1School of Pharmacy and Keck School of Medicine, University of Southern California, Los Angeles
  • 2Department of Medicine, Saint Louis University School of Medicine, St Louis, Missouri
JAMA Cardiol. 2017;2(5):467-468. doi:10.1001/jamacardio.2017.0084

Prevention of readmissions for heart failure (HF) is a distinct challenge, as up to 25% of patients require rehospitalization within 30 days.1 Although rates have fallen, progress has stalled.2 Currently, readmission prevention programs focus on patient education, self-care initiatives, telephonic follow-up, medication reconciliation, and weight monitoring,3 which are founded on behavior-modification, personnel-dependent models. However, consistent and reproducible improvements in 30-day readmission rates have not been demonstrated, and increasing the number of conventional interventions may not affect readmission rates to a degree that justifies added expenditures.4 Conversely, while lengths of stay are demonstrably longer in Europe, readmission rates are lower. Whether this reflects lower-intensity decongestion or simply prolongation of standard therapy is not known.