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Post-acute Care for Patients with Heart Failure

  • Elderly and Heart Disease
  • Published:
Current Cardiovascular Risk Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Patients hospitalized for heart failure (HF) frequently require post-acute care (PAC) services after discharge. This review highlights recent updates on HF patient demographics, risk predictors for adverse outcomes, and management strategies for patients with HF in post-acute care settings, particularly within skilled nursing facilities (SNFs) and home health care (HHC).

Recent Findings

PAC is increasingly utilized for older patients who require ongoing intensive services in order to achieve physical or medical stability after a hospitalization for HF. Patients admitted to SNF and/or HHC frequently have multiple comorbid illnesses and suffer from functional and/or cognitive impairment. These patients are particularly vulnerable to adverse events, including rehospitalization or mortality. Deficits in transitional care, lack of standardized disease management protocols in PAC, and the higher complexity of comorbid illness in this population contribute to their poor outcomes. Legislative initiatives have emphasized improving the quality and efficiency of care delivery in PAC. Interventions that improve care transitions, delivery of care within SNFs, and patient education have shown promise in improving outcomes.

Summary

Patients with HF in PAC have high medical acuity and need consistent and focused HF care to improve outcomes. Transitions between the hospital and PAC are a perilous time for these patients and new innovative practices of care are promising.

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Authors and Affiliations

  1. Division of Cardiology, Tufts Medical Center, Boston, USA

    Nicole M. Orr

  2. Post-Acute Cardiology Care, LLC, Darien, CT, USA

    Nicole M. Orr

  3. Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, USA

    Christine D. Jones

  4. Division of Geriatric Medicine, University of Colorado School of Medicine, 12631 E. 17th Ave., Mail Stop B179, Aurora, CO, 80045, USA

    Andrea E. Daddato & Rebecca S. Boxer

  5. Veterans Affairs Eastern Colorado Geriatric Research Education and Clinical Center, Denver, USA

    Rebecca S. Boxer

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Correspondence to Rebecca S. Boxer.

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Nicole Orr, Christine Jones and Andrea Daddato declare that they have no conflict of interest. Rebecca Boxer reports grants from the National Heart, Lung, and Blood Institute.

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This article is part of the Topical Collection on Elderly and Heart Disease

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Orr, N.M., Jones, C.D., Daddato, A.E. et al. Post-acute Care for Patients with Heart Failure. Curr Cardiovasc Risk Rep 12, 18 (2018). https://doi.org/10.1007/s12170-018-0583-8

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