Vulnerable populations with heart failure less likely to receive early physician followup after discharge
Research Activities, June 2012, No. 382
One-fourth of Medicare patients hospitalized for heart failure (HF) are readmitted within 30 days after discharge. To decrease risk of readmission, early physician followup (within 7 days of hospital discharge) is important. However, only 38 percent of patients receive early followup after discharge from a heart failure hospitalization, according to a recent study.
Women and blacks were less likely to receive early followup. Patients with lower socioeconomic status and patients in rural areas were also less likely to have early followup, while patients living in hospital-referral regions with higher concentrations of physicians were more likely to receive early followup. In addition, patients at high risk for readmission, such as those with kidney disease and chronic obstructive pulmonary disease, were less likely to receive early followup. The reasons for this seemingly paradoxical finding are unclear.
The researchers suggest that sicker patients may have more difficulty arranging physician visits or may tend to be referred to specialists with longer wait times for visits. The study linked patient characteristics with the likelihood of early followup for 30,136 Medicare patients from 225 hospitals during 2003-2006. The researchers concluded that strategies are needed to ensure access among vulnerable populations to this supply-sensitive resource. This study was supported in part by the Agency for Healthcare Research and Quality (HS16964).
See "Associations of patient demographic characteristics and regional physician density with early physician follow-up among Medicare beneficiaries hospitalized with heart failure" by Robb D. Kociol, M.D., Melissa A. Greiner, M.S., Gregg C. Fonarow, M.D., and others in the American Journal of Cardiology 108, pp. 985-991, 2011.