Mixed bag for heart failure patients: less time in hospital but bigger risks at home
First the good news: Medicare beneficiaries are experiencing shorter hospital stays and lower rates of in-hospital deaths after suffering heart failure. Now the not-so-good news: Out-of-hospital deaths and readmission rates are rising, according to a new study. Discharges to nursing homes also are increasing.
Between 1993 and 2006, the average length of stay in a hospital for a Medicare beneficiary suffering heart failure fell from 8.8 days to 6.3 days, according to the new report from Yale University. The in-hospital death rate also declined from 8.5% to 4.3%. Meanwhile, the rate of out-of-hospital deaths rose during that time from 4.3% to 6.4%. Readmission rates climbed to 20.1% from 17.1%, the analysis of more than 7 million Medicare-funded heart failure hospitalizations found. Between 1996 and 2006, the percentage of discharges to nursing homes jumped from 13% to almost 20%.
There is no incentive for hospitals to look at what was happening to patients after discharge, according to study author Dr. Harlan M. Krumholz. Better hospital discharge practices could improve out-of-hospital results, he said. The report appears in the June 2 issue of the Journal of the American Medical Association.