Nav: Home

Higher hospital readmission rates for cardiac patients in Northern vs. Southern Ontario: Importance

February 28, 2019

Philadelphia, February 28, 2019 - Patients hospitalized with heart attacks, heart failure, atrial fibrillation or stroke in Northern Ontario, Canada, were more likely to be readmitted to the hospital and repeatedly hospitalized after discharge than those living in Southern Ontario. Yet, no geographical differences were found in 30-day survival. A new study published in the Canadian Journal of Cardiology recommends providing access to timely transitional care by clinicians who have the knowledge and expertise to treat patients recently discharged from hospital as one of several strategies necessary to reduce hospital readmission rates.

"Hospital readmissions are costly to the healthcare system, but they are also potentially avoidable. Reducing readmission may lead to lower costs of care, which we found tended to be higher in Northern Ontario at one-year follow-up. Our study highlights some of the differences in outcomes and the need for new strategies to try to reduce readmission rates for cardiac disease patients in the North," said Douglas Lee, MD, PhD, the Cardiovascular Program Lead and Senior Scientist at the Institute for Clinical Evaluative Sciences and the Ted Rogers Centre for Heart Research. Dr. Lee is also associated with the Peter Munk Cardiac Centre of the University Health Network and is a Professor of Medicine at the University of Toronto, Ontario, Canada.

The study compared death and readmission risks of patients admitted with acute myocardial infarction (AMI), heart failure (HF), stroke or atrial fibrillation (AF) in Northern compared to Southern Ontario. Northern Ontario regions tend to be more rural, have fewer doctors, and less access to specialist care and important diagnostic tests. However, even when urban or rural region of residence was considered, patients with these four conditions were more likely to be rehospitalized in the North, despite accounting for several factors including bed availability and length of hospital stay.

A key finding was that patients living in the North did not differ from those in the South in their survival at 30 days, and the survival of patients with HF, AF, and stroke did not differ even after one year.

Data were captured from several databases including the Canadian Institute for Health Information Discharge Abstract Database for all hospitalizations and readmissions from April 1, 2005 to March 31, 2015. The report focused on almost 48,000 patient hospitalizations in the Northern region and more than 465,000 hospitalizations in the Southern region. Generally similar observations were found for HF, AF, and stroke.

"Our study supports the finding that geographic factors may be of greater importance for readmission outcomes than rurality, because all cardiovascular conditions exhibited higher readmission rates in both rural and urban regions in the North," noted Dr. Lee, who hopes that the different regions can learn from each other through greater exchange of ideas and strategies.

The authors suggest that among the multiple potential reasons for high readmission rates in Northern Ontario, reduced access to post-discharge care is one plausible explanation. "Cardiovascular medicine is becoming increasingly complex, and it will require the combined efforts of specialists and primary care physicians to result in the best outcomes and quality of care for our patients," commented Dr. Lee. He suggests that programs such as the Ontario Telemedicine Network, mobile health services, and travel grants may lead to improved health accessibility in Northern regions.
-end-


Elsevier

Related Heart Failure Articles:

Type 2 diabetes may affect heart structure and increase complications and death among heart failure patients of Asian ethnicity
The combination of heart failure and Type 2 diabetes can lead to structural changes in the heart, poorer quality of life and increased risk of death, according to a multi-country study in Asia.
Preventive drug therapy may increase right-sided heart failure risk in patients who receive heart devices
Patients treated preemptively with drugs to reduce the risk of right-sided heart failure after heart device implantation may experience the opposite effect and develop heart failure and post-operative bleeding more often than patients not receiving the drugs.
How the enzyme lipoxygenase drives heart failure after heart attacks
Heart failure after a heart attack is a global epidemic leading to heart failure pathology.
Novel heart pump shows superior outcomes in advanced heart failure
Severely ill patients with advanced heart failure who received a novel heart pump -- the HeartMate 3 left ventricular assist device (LVAD) -- suffered significantly fewer strokes, pump-related blood clots and bleeding episodes after two years, compared with similar patients who received an older, more established pump, according to research presented at the American College of Cardiology's 68th Annual Scientific Session.
NSAID impairs immune response in heart failure, worsens heart and kidney damage
Non-steroidal anti-inflammatory drugs, or NSAIDs, are widely known as pain-killers and can relieve pain and inflammation.
Heart cell defect identified as possible cause of heart failure in pregnancy
A new Tel Aviv University study reveals that one of the possible primary causes of heart failure in pregnant women is a functional heart cell defect.
In heart failure, a stronger heart could spell worse symptoms
Patients with stronger-pumping hearts have as many physical and cognitive impairments as those with weaker hearts, suggesting the need for better treatment.
Patients with common heart failure more likely to have lethal heart rhythms
New Smidt Heart Institute Research shows that patients with Heart Failure with Preserved Ejection Fraction (HFpEF) are more likely to have lethal heart rhythms.
Why does diabetes cause heart failure?
A Loyola University Chicago Stritch School of Medicine study reveals how, on a cellular level, diabetes can cause heart failure.
Oxygen therapy for patients suffering from a heart attack does not prevent heart failure
Oxygen therapy does not prevent the development of heart failure.
More Heart Failure News and Heart Failure Current Events

Top Science Podcasts

We have hand picked the top science podcasts of 2019.
Now Playing: TED Radio Hour

Risk
Why do we revere risk-takers, even when their actions terrify us? Why are some better at taking risks than others? This hour, TED speakers explore the alluring, dangerous, and calculated sides of risk. Guests include professional rock climber Alex Honnold, economist Mariana Mazzucato, psychology researcher Kashfia Rahman, structural engineer and bridge designer Ian Firth, and risk intelligence expert Dylan Evans.
Now Playing: Science for the People

#540 Specialize? Or Generalize?
Ever been called a "jack of all trades, master of none"? The world loves to elevate specialists, people who drill deep into a single topic. Those people are great. But there's a place for generalists too, argues David Epstein. Jacks of all trades are often more successful than specialists. And he's got science to back it up. We talk with Epstein about his latest book, "Range: Why Generalists Triumph in a Specialized World".
Now Playing: Radiolab

Dolly Parton's America: Neon Moss
Today on Radiolab, we're bringing you the fourth episode of Jad's special series, Dolly Parton's America. In this episode, Jad goes back up the mountain to visit Dolly's actual Tennessee mountain home, where she tells stories about her first trips out of the holler. Back on the mountaintop, standing under the rain by the Little Pigeon River, the trip triggers memories of Jad's first visit to his father's childhood home, and opens the gateway to dizzying stories of music and migration. Support Radiolab today at Radiolab.org/donate.