A community hospital-based congestive heart failure program: Impact on length of stay, admission and readmission rates, and cost

Objective: To do an analysis of patients with a primary diagnosis of conges tive heart failure at discharge before (n = 407) and after (n = 347) the im plementation of a comprehensive inpatient and outpatient congestive heart f ailure program consistent with the guidelines of the Agency for Health Care Policy and Research. Study Deign: A retrospective analysis of the impact of the congestive heart failure program on length of stay, admission and readmission rates, and co sts to both patient and provider. The program, which used a multidisciplina ry team approach, included an intensive education program focusing on diet, compliance, and symptom recognition, as well as the use of outpatient infu sions. It also incorporated aggressive pharmacologic treatment for patients with advanced congestive heart failure. Results: Our analysis revealed significant decreases in length of stay, adm ission and readmission rates, and costs to the patient and provider (P less than or equal to .05). The mean cost per admission decreased 17% ($1118), and a substantial 77% ($718,468) net reduction in nonreimbursed (lost) hosp ital revenue was noted. Conclusion: A multidisciplinary, comprehensive congestive heart failure pro gram can improve patient care in a community-hospital setting while signifi cantly reducing costs to both the patient and the institution.