Clincal study
Randomized trial of an education and support intervention to preventreadmission of patients with heart failure

https://doi.org/10.1016/S0735-1097(01)01699-0Get rights and content
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Abstract

Objectives

We determined the effect of a targeted education and support intervention on the rate of readmission or death and hospital costs in patients with heart failure (HF).

Background

Disease management programs for patients with HF including medical components may reduce readmissions by 40% or more, but the value of an intervention focused on education and support is not known.

Methods

We conducted a prospective, randomized trial of a formal education and support intervention on one-year readmission or mortality and costs of care for patients hospitalized with HF.

Results

Among the 88 patients (44 intervention and 44 control) in the study, 25 patients (56.8%) in the intervention group and 36 patients (81.8%) in the control group had at least one readmission or died during one-year follow-up (relative risk = 0.69, 95% confidence interval [CI]: 0.52, 0.92; p = 0.01). The intervention was associated with a 39% decrease in the total number of readmissions (intervention group: 49 readmissions; control group: 80 readmissions, p = 0.06). After adjusting for clinical and demographic characteristics, the intervention group had a significantly lower risk of readmission compared with the control group (hazard ratio = 0.56, 95% CI: 0.32, 0.96; p = 0.03) and hospital readmission costs of $7,515 less per patient.

Conclusions

A formal education and support intervention substantially reduced adverse clinical outcomes and costs for patients with HF.

Abbreviations

CI
confidence interval
CVD
cardiovascular disease
HF
heart failure
HR
hazard ratio
RR
relative risk
YNHH
Yale-New Haven Hospital

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