Influencia sobre la hospitalización de una consulta monográfica para pacientes con nsuficiencia cardiaca dirigida por internistas. Estudio de cohortes

Abstract

Objetive: The target of this study is to determine the impact of a monographic consultation for Chronic Heart Failure (CHF) which internists and specialized nursing have a main role, on the hospitalization of those patients. Material and Methods: Prospective cohort study included 456 patients admitted to the Internal Medicine Unit with CHF. Upon discharge patients were divided into two similar groups, one control group that went through routine monitoring, and one intervention group made of patients subject to monitoring through monographic consultation for CHF. The study was conducted from January 6th to April 9th. Both cohorts were compared in terms of the number of urgent service visits, hospital readmissions, readmission rates and mortality average at hospital admission. Results : The number of ER visits of patients subject to monitoring through monographic consultation as opposed to control group was considerably lower (66% vs 155%) (p<0,001); the readmission rate was significantly reduced (81% vs 50.5%) (p=0,002); the average hospital stay was significantly lower (18 days vs 25 days) (p<0,001). And the mortality upon readmission was 13% lower as opposed to 27.8% (p<0�006). Conclusion: In CHF and comorbility patients, following a health program in which internists and specialized nursing have a main role and which is based on a continuous and integral tracking, information / training and availability, is a good way to reducing urgents visits and readmissions, as well as reducing hospital stay and mortality.