Specialized Care Cuts Costs for Elderly Heart Patients

When elderly heart-failure patients receive specialized nursing care throughout their hospital stay and at home following discharge, they have a better quality of life, fewer readmissions, and their care costs nearly 38% less, according to a study in the May 2004 issue of the Journal of American Geriatrics Society.

Elderly patients with heart failure typically have the highest rate of hospitalization. Six U.S. academic and community hospitals participated in a study on transitional care intervention for 239 elderly patients, 65 or older, who had suffered an acute episode of heart failure. Half were assigned to the group receiving transitional care and half assigned to a control group. Patients in the transitional group were visited by advanced-practice nurses within 24 hours of admission and, upon discharge, the nurses conducted home visits within 24 hours and were available by phone. Patients were followed for one year after discharge.

The study showed that while the total costs of providing this level of care were nearly double that provided to patients receiving routine care, this increase was more than offset by cost savings from fewer hospital readmissions, resulting in a 37.6% savings per patient over 12 months. As a result of these findings, a major health insurer has launched a U.S.$1million pilot program to test the research in practice.

"The goal was to provide these chronically ill patients and their families with the knowledge and management skills necessary to prevent poor outcomes and avoid the need for acute care,” said Mary Naylor, Ph.D., RN, professor of nursing at the University of Pennsylvania, (Philadelphia, USA), who led the study.





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