The better heart failure patients know docs, the better their survival rates

Heart failure patients who follow up with a familiar doctor after being discharged from the hospital have a higher survival rate and lower readmission rate than those seeing a doctor they don't know, according to research published Monday in the Canadian Medical Association Journal (CMAJ).

The study looked at survival rates over a 10-year period for patients discharged from the hospital with a first-time diagnosis of heart failure. A familiar physician was one who had seen the patient at least twice in the year before the admission or once during the admission.

The highest death rate (62.9 percent) was among patients who had no follow-up visits in the month following hospitalization, compared with 43.6 percent among those who saw a doctor following discharge.

But among those who continued to see doctors over six months, the risk of death or urgent readmission was lower when patients exclusively saw a familiar physician, the researchers found.

"The absolute reduction of 3 percent to 8 percent in risk of death or urgent readmission ... observed over 3-12 months in association with follow-up in the first month after discharge was in the same range as the absolute benefits seen in placebo-controlled randomized trials of angiotensin-converting-enzyme inhibitor or b-blocker therapy," the authors wrote in their online report, according to the research announcement.

The authors said more research is needed to determine whether the same effect would be seen with other health conditions or among patients other than those recently discharged from the hospital.

Meanwhile, a separate program in North Carolina involving intensive follow-up with Medicaid patients found patients with complex, chronic conditions who received transitional care were 20 percent less likely to be readmitted in the year after hospitalization. One readmission was averted for every three of the patients at highest risk of readmission.

For more information:
- here's the study abstract
- read the research announcement