Annually more than 1 million patients are hospitalized with a primary diagnosis of heart failure accounting for a total Medicare expenditure exceeding $17 billion (Desai, 2012).
A care coordination measure improved quickly (average annual rate of change >10% per year) are hospital patients with heart failure who were given complete written discharge instructions.
- Effective care coordination begins by ensuring that accurate clinical information is available to support medical decisions by patients and providers.
- A common transition of care is hospital discharge.
- A successful transition depends on whether hospitals have adequately educated patients about key elements of care, such as diagnosis and follow-up plans (Horwitz, et al., 2013).
Trends for patients with heart failure given complete written discharge planning instructions:
- From 2005 to 2013, the percentage of hospitalized adult patients with heart failure who were given complete written discharge instructions improved from 57.4% to 94.6%.
- Improvements were observed among both sexes and all racial/ethnic groups.
Groups with disparities:
- In all years, there were no statistically significant differences by sex.
- In all years, the percentage of hospitalized adult patients with heart failure who were given complete written discharge instructions was lower for American Indians and Alaska Natives (AI/ANs) than for Whites.
- The 2012 top 5 State achievable benchmark was 96.2%. The top 5 States that contributed to the achievable benchmark are Illinois, Maine, New Hampshire, New Jersey, and Ohio.
- At the current rates of increase, this benchmark could be attained overall and by both sexes in less than a year. All racial/ethnic groups could attain the benchmark in less than a year except AI/ANs, who could achieve the benchmark in about 1 year.
Importance: Health care provider-patient communication about prognosis and preferences for care is critical in helping patients adequately prepare for and plan future care, and physicians’ communication style may affect patients’ satisfaction, trust, willingness to cooperate, and health status.
In comparison, patients with heart failure not receiving complete written discharge planning instructions:
- From 2009 to 2014, the percentage of adult hospital patients who did not receive good communication about discharge information improved from 15.8% to 11.3%.
- From 2009 to 2014, improvements were observed among all racial and age groups.
Groups with disparities:
- In all years, Black and Asian patients were less likely than White patients to receive good communication about discharge information.
- In all years except 2012, AI/AN patients were less likely than White patients to receive good communication about discharge information.
Importance: Comprehension of and compliance with discharge instructions can reduce emergency department visits and rehospitalizations, improve post-discharge health outcomes, and decrease health care expenditures.