Treatments

Sending Heart Failure Patients Home Too Soon Can Backfire

Nobody wants to be in the hospital. And even the people who run hospitals don't want you to stay there a moment longer than you have to.

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But research appearing in the latest issue of JAMA suggests that the push to send patients home quickly may have gone a little too far when it comes to heart failure.

Between 1996 and 2003, the average length of time Medicare patients spent in the hospital for heart failure fell by 2 1/2 days — to 6.3 days from 8.8 days. Death rates soon after discharge went up and readmissions to the hospital did too.

"At a time when we were focusing on shortening that length of stay we might have been actually worsening some of the outcomes for patients," Yale cardiologist Harlan Krumhotz, senior author on the paper, said in a JAMA video.

There was no breakthrough in the short-term treatment for heart failure during the 14-year period, the study's authors note, but there were strong financial incentive for hospitals to shorten stays.

But the savings reaped by hospitals were probably overwhelmed by additional spending on outpatient care and readmissions, Krumholz told the Wall Street Journal. Patients were released "faster and we capped initial hospital costs, but the downstream costs may have increased," he said. The study didn't look specifically at costs, however.

And, it should be pointed out that the overall mortality rates in the 30 days after someone was first admitted to the hospital for heart failure fell about two percentage points to 10.7 percent during the study period.

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