As reported in today's Daily Briefing, heart failure (HF) patients who have follow-up visits with a health care professional within seven days of hospital discharge have a 15% lower 30-day readmission rate than patients who do not have such a visit, a study in JAMA finds.
For the study, researchers from Duke University School of Medicine assessed data on 30,136 Medicare patients with HF treated at 225 hospitals between January 2003 and December 2006. Overall, rates of physician follow-up within one week after discharge were low and varied across hospitals.
Specifically, the researchers found that although nearly 94% of HF patients were scheduled for a follow-up, an average of just 38.3% of patients actually had a visit within a week after discharge. The majority of patients who received early follow-up care were seen by a general internist, while only 7.5% of these patients were seen by a cardiologist. Overall, approximately 21% of HF patients were readmitted within 30 days.
JAMA: Follow-ups reduce readmission among HF patients
Though many have voiced concerns over the need for CTA in many cases and the potentially unnecessary cost burden, a recent study published in the American Journal of Cardiology reports that physicians found 98% of CTA exams helpful in treating patients. The research was conducted at Massachusetts General Hospital by Ron Blankstein, MD, who reviewed 108 patients who received computed tomographic angiography (CTA) to assess coronary artery disease (CAD) and whose referring physicians completed surveys to gauge the impact of the results. Referring physicians were predominately cardiologists (79%), while 19% were primary care physicians.
Survey respondents reported that 98% of the scans were helpful, with a mean usefulness score of 8.9 +/- 1.5 on a scale of 1 to 10, with 10 being "extremely helpful." Test results prompted physicians to reclassify the patient's CAD risk in more than half of patients and change medical therapy in 35% of patients, suggesting the value of the results in refining patient care.
Also interesting was the physicians' reports regarding their choices were CTA not an option. Almost half of respondents said they would have ordered invasive angiography (46%), especially in symptomatic patients, suggesting that providing the option for CTA may prevent the need for more expensive, invasive testing.