Impact of Congestive Heart Failure Discharge Planning on Congestive Heart Failure Re-Admission Rates

Background: Congestive Heart Failure (CHF) is the most common diagnosis accounting for more healthcare costs than any diagnosis. CHF readmissions contribute significantly to this expenditure. Quality of care in heart failure is linked to process based performance measures. This study evaluated the relationship between adherence to performance metrics and 30 day readmission rates. Methods: This was a single center case-control study that evaluated 6063 consecutive patients admitted with CHF from December 2001 through December 2008. Data was collected for readmission to the hospital within 30 days and compliance to the heart failure performance measures at discharge. Results: The rate of readmission for CHF increased steadily from 16.8% in 2002 to 24.8% in 2008. Adherence to CHF performance measures increased concurrently during the same time frame from 88.7% to 98.9%.Except for left ventricular function (LVF) assessment, 30 day readmission rate was not associated with adherence to performance measures. Readmitted patients had twice the odds of not having their LVF assessed (OR: 2.0; p<0.00005; 95% CI: 1.45-2.63) Conclusions: Heart failure performance measures, except for the assessment of left ventricular function have little relationship with 30 day hospital readmissions after discharge. More studies need to be done to identify performance measures that correlate with quality of care in heart failure patients.