A recent study finds that repeat emergency department (ED) visits for acute heart failure suggest a lack of appropriate outpatient care. It was found that nearly one-third of acute heart failure syndrome (AHFS) patients seen in hospital emergency departments in Florida and California had ED visits during the following year.

The study was conducted by Massachusetts General Hospital (MGH) and was supported by the Eleanor and Miles Shore Fellowship Program of Harvard Medical School and by the Honjo International Scholarship Program of Tokyo, Japan. The results of the study have been published in Circulation: Cardiovascular Quality and Outcomes.

The investigators also found that patients with frequent ED visits for heart failure syndrome accounted for more than half of all ED visits and hospitalisations. This translates into a significant increase in healthcare costs.

According to Kohei Hasegawa, MD, MPH, MGH Department of Emergency Medicine and the corresponding author of the report, "“The high proportion of patients with frequent ED visits reflects the failure of current measures to manage heart failure symptoms, Our finding also suggests that quality improvement efforts focusing only on hospital admissions may provide an incomplete picture of the utilisation of health care services by discounting the importance of pre-admission ED visits.” The co-authors of the report include Carlos Camargo, MD, DrPH, and David Brown, MD, MGH Department of Emergency Medicine, and Yusuke Tsugawa, MD, MPH, Harvard Inter-faculty Initiative in Health Policy.

The authors of the report reveal that AHFS accounts for more than 675,000 ED visits and nearly one million hospitalisations in the US every year. This translates into a cost of approximately $31 million. A majority of these ED visits can be prevented through improved outpatient care.

The study investigators analysed information from databases covering ED visits and inpatient admissions in Florida and California. It was found that out of the 113,000 adult patients with at least one ED visit for AHFS, approximately 70 percent had no repeat visits for the next 12 months. However, 30 percent of patients returned to the ED at least once in the following year. Nearly 55 percent of the frequent ED visits were comprised of patients following up on AHFS.

The report projects that high-quality outpatient care could prevent 62,000 repeat ED visits and over 52,000 hospital admissions. This could save more than $1 billion for the state of Florida alone. The results also confirmed previous findings that excessive ED visits for AHFS resulted in disproportionate service utilisation for other patients, especially those with asthma or chronic obstructive pulmonary diseases.

Source: Massachusetts General Hospital
Image Credit: Wikimedia Commons

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emergency department, acute heart failure syndromes, hospital admissions, outpatient care, healthcare costs A recent study finds that repeat emergency department (ED) visits for acute heart failure suggest a lack of appropriate outpatient care. It was found that...