Congestive heart failure disease management program: 1-Year population experience from a tertiary center heart failure registry in Saudi Arabia

Abstract

AimsWe aimed to evaluate congestive heart failure (CHF) multidisciplinary disease management program (DMProg) impact on mortality, readmission rates, length of stay (LOS), and gender health characteristics. Methods and resultsThis was a quasi-observational, pre- and post-trial with a parallel nonequivalent group. We enrolled 174 inpatients having CHF with reduced ejection fraction and New York Heart Association (NYHA) Class II–IV, and a total of 197 hospital admissions. A comparative follow-up was performed from 15 December 2014 to 15 December 2015. Among 197 consecutive hospital admissions, 76 (39%) were included in the preintervention or usual care group and 121 (61%) were assigned to the postintervention group. After 1year, in comparison with the preintervention group, the postintervention group had shorter average LOS in days (7.6days vs. 11.1days, p<0.002), lower 1-year readmission rate (36% vs. 57%, p<0.003), and lower in-house mortality (1.6% vs. 7.8%, p=0.03), but similar baseline mortality scores (38.2 vs. 38.6, p=0.7), 30-day and 90-day readmission rates (15% vs. 18.3%, p=0.62 and 27.6% vs. 30%, p=0.65), and 30-day readmission risk score (24.9% vs. 26.2%, p=0.09). By regression analysis, the DMProg intervention was an independent factor for 1-year readmission reduction (p=0.001). Kaplan–Meier survival analysis favored the postintervention group (log-rank, p<0.001). ConclusionDMProg significantly decreased 1-year readmission rates, LOS, and in-house mortality.