Hospital program saves heart failure patients from re-admission

Treating an inpatient with congestive heart failure costs Health Sciences North about $1,000 a day.

On average, a patient with the disease is admitted to hospital for 10.8 days. More than 20 per cent of patients are re-admitted to hospital after 30 days, for an additional 10.8 days.

Congestive heart failure refers to the heart's inability to pump blood as effectively as it should, meaning tissues of the body are not receiving enough blood and oxygen.

The condition leads to an increase in pressure in the blood vessels, which forces fluid from these vessels into body tissues and organs such as the lungs, legs and feet.

Patients with congestive heart failure are often difficult to treat, as they will have a host of other ailments, ranging from diabetes to depression, said Dr. Atilio Costa Vitali, medical director of Health Sciences North's Heart Failure Disease Management Program.

The program manages an outpatient clinic for 400 people with congestive heart failure. By closely monitoring their health, the hospital can improve their outcomes and reduce the number of long-term admissions.

In 2012 the hospital studied the progress of 80 heart failure patients who were referred to the Heart Failure Disease Management Program and the Infusion Clinic.
Only three (3.75 per cent) of those patients were readmitted to hospital within 30 days due to heart failure.

Based on these findings, researchers at the hospital estimate the clinic could save the health-care system more than $750,000 a year in reduced re-admissions and medical interventions.

But the 400 patients only represent a small fraction of the people in the Greater Sudbury Area with congestive heart failure.

Vitali said less than 10 per cent of congestive heart failure patients in Canada are being referred to clinics like the one he manages.

Patients are referred to the Heart Failure Disease Management Program through family physicians, cardiac specialists and through the hospital's emergency department.

“Because of the shortage of physicians we have in Canada, these patients, unfortunately, are not being followed up the way they should be,” Vitali said.

Patients with congestive heart failure should have a follow-up with their doctor every two weeks so their medication can be re-assessed. But most patients only have a follow-up every two to six months, Vitali said.

The program can manage its 400 patients, but Vitali said it will need to expand to serve the area's larger patient population.

By reducing the amount of patient re-admissions, through the program, Vitali said the health system would save money, and patients would be more closely monitored before requiring intensive care.

@jmigneault