Treatment for older people with heart failure has improved by several measures. Patients today have shorter hospital stays and lower rates of death while in the hospital. However, the rates of hospital readmission have increased, which may signal that care for this serious illness isn't as good as it could be.
Researchers analyzing Medicare data from 1993 to 2006 found that the average length of a hospital stay for heart failure declined from 8.8 days in 1993 to 6.3 days in 2006 while in-hospital death rates declined from 8.5% to 4.3% during the same time period.
However, the patients may be sicker when they leave the hospital. The study, released Tuesday in the Journal of the American Medical Assn., found that deaths occurring within 30 days of discharge rose from 4.3% to 6.4% over the 14 years studied. Readmission to the hospital within 30 days increased from 17.2% to 20.1% Moreover, the ratio of patients who were discharged from the hospital to skilled nursing facilities increased from 13% to 19.9%.
It's troubling to see an uptick in patients who have to be readmitted or go to skilled nursing facilities, the authors of the study noted.
"Although we cannot demonstrate that the shortened hospital stay caused these changes, it is certainly plausible that the effort to discharge patients quickly has led to transfers to nonacute institutional settings and occasionally sent patients out of the hospital before they were fully treated," they wrote.
-- Shari Roan
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