Heart Failure Patients Often Do Not Receive Necessary Outpatient Follow-Up: Study

Individuals treated in the emergency room for heart failure often do not get timely follow-up care, and face an increased risk of hospitalization, according to the findings of a new study.

In a report published this month in the medical journal Circulation: Cardiovascular Quality and Outcomes, researchers from the Perelman School of Medicine at the University of Pennsylvania found that nearly 20% of patients discharged from the ER after suffering acute heart failure end up hospitalized again before they get needed follow-up care, highlighting the need for earlier outpatient follow up and self-care strategies.

Researchers conducted a retrospective cohort study using information from an administrative claims database for large US commercial insurers, which included data on 52,732 adult patients discharged from the ER with a diagnosis of heart failure from 2012 to 2019. Patients were an average of 74 years old, and researchers focused on outpatient clinic visits for heart failure within 30 days after visiting the ER for a cardiovascular event.

The data indicates patients discharged from the ER after acute heart failure are at high risk for return hospitalization within 30 days. Researchers found 23% of acute heart failure patients who were treated in the ER later attended an outpatient clinic visit for follow up treatment within 30 days. However, 16% of patients treated in the ER were hospitalized within 30 days before they could be treated at outpatient clinic visits for heart failure.

“Few patients obtain timely outpatient follow-up after emergency department visits for heart failure, although nearly 20% require hospitalization within 30 days,” researchers determined. “Improved transitions following discharge from the emergency department may represent an opportunity to improve outcomes for patients with acute heart failure.”

Patients that were younger, women, Black, and had fewer previous clinic visits were less likely to have an outpatient follow visit within 30 days and more likely to be hospitalized as a result.

Researchers highlight the need for timely outpatient follow-up care to reassess health, interventions and self-care strategies. Many heart failure patients lack adequate interventions and self-care steps to continue to improve their health and prevent further deterioration, which would eventually land them back in the hospital.

The study found healthcare providers fail to highlight the need for early follow-up after heart failure. Ideally, heart failure patients should have an outpatient care clinic follow up appointment within seven days; however this is rarely done.

Follow up should include focus blood pressure monitoring, fluid retention monitoring heartbeat, assessing the lungs and other symptoms of heart failure to attempt interventions before patients require additional serious treatment.