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Outcomes in Acute Heart Failure: 30-Day Readmission Versus Death

  • Epidemiology of Heart Failure (CSP Lam, Section Editor)
  • Published:
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Abstract

For patients hospitalized with acute heart failure, health policy initiatives in the USA have drawn attention to 30-day mortality and readmission. Confusion around definitions, populations, and thus reported rates for these two outcomes is common. Among Medicare fee-for-service patients hospitalized with heart failure, all-cause mortality 30 days from the time of admission is 11.7 % and all-cause unplanned readmission 30 days from discharge is 23.0 %. Rates for Medicaid and commercially insured patients are lower. Mortality rates have been relatively stable, while readmission rates increased under the Diagnosis Related Group payment system then began decreasing under the Hospital Readmission Reductions Program. Risk models are reasonable at predicting mortality, whereas readmission has been harder to anticipate. The use of risk-standardized hospital rates as performance measures has generated considerable debate. Future work should clarify the interaction between the two measures, the optimal time window and factors influencing rates and trends—including socioeconomic status.

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Acknowledgments

Larry A. Allen is supported by a grant from the National Institutes of Health National Heart, Lung, and Blood Institute (Grant # K23HL105896).

Compliance with Ethics Guidelines

ᅟ

Conflict of Interest

Colleen K. McIlvennan declares that she has no conflict of interest.

Larry A. Allen has received compensation from Amgen for service on a scientific advisory panel and compensation from Johnson & Johnson/Janssen Pharmaceuticals for service on a steering committee.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Section of Advanced Heart Failure and Transplantation, Division of Cardiology, University of Colorado School of Medicine, 12631 East 17th Avenue, B130, Aurora, CO, 80045, USA

    Colleen K. McIlvennan & Larry A. Allen

  2. Colorado Cardiovascular Outcomes Research Consortium, Denver, CO, USA

    Colleen K. McIlvennan & Larry A. Allen

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  1. Colleen K. McIlvennan
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Correspondence to Colleen K. McIlvennan.

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McIlvennan, C.K., Allen, L.A. Outcomes in Acute Heart Failure: 30-Day Readmission Versus Death. Curr Heart Fail Rep 11, 445–452 (2014). https://doi.org/10.1007/s11897-014-0215-7

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  • DOI: https://doi.org/10.1007/s11897-014-0215-7

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