This article is more than 5 years old. Information may no longer be current.
Health care costs lower with home-based chronic HF management
Click Here to Manage Email Alerts
In a head-to-head comparison of multidisciplinary chronic HF management, no difference was found in unplanned all-cause hospitalization or death between home-based and clinic-based intervention. However, home-based intervention was found to reduce health care costs.
Total health care costs were about 30% lower for patients who received home-based intervention vs. clinic-based intervention. The reduction in costs was attributed to a shorter median duration of each unplanned hospitalization associated with home-based management of chronic HF, researchers said.
For the prospective, multicenter, randomized trial, 280 hospitalized patients with chronic HF (73% men; mean age, 71 years) were randomly assigned to home-based intervention or specialized clinic-based intervention. Follow-up was conducted at 12 and 18 months.
The primary endpoint was all-cause, unplanned hospitalization or death. This was reported in 71% of the home-based intervention group vs. 76% of the clinic-based intervention group (adjusted HR=0.97; 95% CI, 0.73-1.3). Of these, unplanned hospitalization was reported in 67.1% of home-based intervention patients vs. 69.3% of clinical-based intervention patients and 21.7% of home-based intervention patients died vs. 27.7% of clinic-based intervention patients. The home-based intervention group had a significantly shorter median duration of each unplanned hospitalization (4 days vs. 6 days; P=.004). Overall, the researchers said three-quarters of all hospitalization was attributable to 22.9% of patients, of whom 67% were assigned clinic-based intervention (adjusted HR=2.55; 95% CI, 1.37-4.73). Additionally, home-based intervention was associated with fewer days of all-cause and CV-related hospitalization, but not chronic HF-related hospitalization, according to the abstract.
“The fact that we observed the greatest differences with respect to all-cause and CV-related hospitalization in this typically older cohort of chronic HF patients suggests that the benefits of a more generic hospital transition program involving home visits outweigh a more chronic HF-specific focus,” the researchers concluded.
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts