Regional Hospital Collaboration and Outcomes in Medicare Heart Failure Patients See You in 7》.pdf

J A C C : H E A R T F A I L U R E V O L . 3 , N O . 1 0 , 2 0 1 5 ª 2 0 1 5 B Y T H E A M E R I C A N C O L L E G E O F C A R D I O L O G Y F O U N D A T I O N I S S N 2 2 1 3 - 1 7 7 9 / $ 3 6 . 0 0 P U B L I S H E D B Y E L S E V I E R I N C . h t t p : / / d x . d o i . o r g / 1 0 . 1 0 1 6 / j . j c h f . 2 0 1 5 . 0 6 . 0 0 7 Regional Hospital Collaboration and Outcomes in Medicare Heart Failure Patients See You in 7 Harolyn Baker, MPH,* Sandra Oliver-McNeil, DNP,y Lili Deng, MD, MS,* Scott L. Hummel, MD, MSzx ABSTRACT OBJECTIVES The objective of this study was to evaluate an interhospital collaborative approach to improve 7-day post-discharge follow-up (7dFU) rates and reduce 30-day readmissions in heart failure (HF) patients. BACKGROUND Early post-discharge follow-up after HF hospitalization is associated with lower 30-day readmission rates. METHODS Observational analyses of Medicare HF patients discharged from 10 collaborating hospitals (CH) participating in the Southeast Michigan See You in 7 Collaborative were carried out. We compared pre-intervention (May 1, 2011 to April 30, 2012) and intervention (May 1, 2012 to April 30, 2013) 7dFU rates, unadjusted 30-day readmissions, risk- standardized 30-day readmissions (RSRR), and Medicare payments in CH and Michigan nonparticipating hospitals (NPH). RESULTS 7dFU rates increased but remained low in both groups (CH: 31.1% to 34.4%; p 0.001; NPH: 30.2% to 32.6%; p 0.001). During the intervention period, unadjusted readmissions decreased significantly in both groups (CH: 29.0% to 27.3%; p 0.001; NPH: 26.4% to 25.8%, p ¼ 0.004); mean RSRR decreased more in CH than in NPH (CH: 31.1% to 28.5%; p 0.001; NPH: 26.7% to 26.1%, p ¼ 0.02; p ¼ 0.015 for intergroup comparisons). Findings w