Rehospitalization for Heart Failure Predict or Prevent?
Rehospitalization for Heart Failure Predict or Prevent?
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DOI：
10.1161/circulationaha.112.125435
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发表时间：
2012-07-24
期刊：
影响因子：
37.8
通讯作者：
Stevenson, Lynne W.
中科院分区：
文献类型：
--
作者：
Desai, Akshay S.;Stevenson, Lynne W.
心力衰竭是美国65岁以上成年人住院治疗的主要原因。每年有100万名患者因心力衰竭的初步诊断而住院，占医疗保险总支出超过170亿美元。1尽管药物治疗显著改善了预后，2，3心力衰竭住院后的入院率仍然很高，4 50%的患者在出院后6个月内再次入院。5-7由于再入院率的降低可能同时降低成本和提高护理质量，公共和私人支付者越来越多地将再入院作为按绩效付费计划的重点。8 2009年，美国医疗保险和医疗补助服务中心开始公开报告心力衰竭住院后的全因再入院率，次年，《患者保护和平价医疗法案》9规定对出院后前30天内再入院率最高的医院进行经济处罚。越来越多的关注需要减少再入院集中在国家的研究和医院驱动的努力，预测心力衰竭患者可能会再次入院，并设计干预措施，以防止再入院。
Heart failure is the leading cause of hospitalization among adults 65 years of age in the United States. Annually, 1 million patients are hospitalized with a primary diagnosis of heart failure, accounting for a total Medicare expenditure exceeding $17 billion. 1 Despite dramatic improvement in outcomes with medical therapy, 2, 3 admission rates following heart failure hospitalization remain high, 4 with 50% patients readmitted to hospital within 6 months of discharge. 5–7 Because reduction in readmission rates might simultaneously reduce costs and improve quality of care, public and private payers have increasingly targeted readmissions as a focus of pay-for-performance initiatives. 8 In 2009, the US Center for Medicare & Medicaid Services began public reporting of all-cause readmission rates after heart failure hospitalization, and, in the following year, the Patient Protection and Affordable Care Act9 established financial penalties for hospitals with the highest readmission rates during the first 30 days after discharge. Increasing concern regarding the need to reduce readmissions has focused national research and hospital-driven efforts on the prediction of which patients with heart failure are likely to be readmitted and the design of interventions to prevent readmissions.