New research published in the Journal of the American Heart Association suggests that patients with heart failure who were rehospitalised within a month to the same hospital were discharged quicker and were more likely to survive.
Ambulance policies in both the US and Canada require patients to be taken to the nearest emergency room even if the patient was previously hospitalised somewhere else. This policy does make sense in time-sensitive acute conditions since any delays in initial treatment could result in poor outcomes. The adage "time is muscle" has often been used for heart attacks and "time is brain" for strokes as highlights Finlay A. McAlister, MD, MSc., study lead author and professor of general internal medicine at the University of Alberta in Edmonton, Canada.
During this study, the researchers examined readmissions data for all patients who were discharged with a primary diagnosis of heart failure in Canada. 217,039 patients were included in the study out of which 18.1% were readmitted within 30 days. Out of this 18%, 83% of the patients were readmitted to their original hospital and 16.8% were sent to a different hospital. The most common cause of readmission in these patients was heart failure.
Findings showed that heart failure patients who were readmitted to the same hospital were discharged one day sooner on an average and were 11% less likely to die during their hospital stay. Individually speaking, these differences may not be very significant but on a broader scale, this is an important issue especially because heart failure is such a common reason for hospitalisation and readmission as Dr. McAlister explains.
"Patients' hospital records may not be completed for weeks and they don't report all of the things that happened during the initial hospitalisation. For example, it is not uncommon for heart failure patients to not tolerate or have adverse responses to higher doses of some guideline-recommended medications. That information rarely appears on discharge summaries, so patients are at risk of the same thing happening if they are admitted to a different hospital," Dr. McAlister said.
He also recommends booking a follow-up appointment within two weeks of discharge from the hospital. In case condition deteriorates, it is advisable to see a family physician as soon as possible.
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