Does hospitalist care improve heart failure outcomes?

While the use of hospitalists grows nationally, a new study in JACC: Heart Failure questions whether hospitalist care can improve outcomes among older patients with heart failure.

Researchers looked at 31,505 Medicare patients in 166 hospitals and found greater use of hospitalists for managing heart failure patients had no association with 30-day readmissions. Moreover, a 10 percent increase in hospitalist use came with a slight rise in mortality and a small drop in length of stay.

Suggesting a "potential synergy between hospitalist and subspecialty care," the researchers noted a correlation between increased use of hospitalists in hospitals with a high use of cardiologists and better adherence to established heart failure performance measures.

"Ideally, a coordinated approach to hospital care with hospitalists and cardiologists who are well qualified to treat patients with heart failure would translate into better quality of care and improved outcomes," the researchers wrote, MedPage Today reported.

Echoing calls for hospitalist collaboration to help improve outcomes, a Society of Hospital Medicine board member urges hospitalists to engage other providers to safely transition discharged patients and prevent hospital readmissions. "Engaging these physicians, nonphysician providers, and facility administrators is key to our ability to impact this problem," Robert W. Harrington Jr., M.D., wrote this month in The Hospitalist.

Although hospitalist-cardiologist collaboration could help improve outcomes for heart failure patients, a November 2012 study by the Minneapolis Heart Institute Foundation found cardiologists curb more readmissions of heart failure patients than hospitalists, even when patients' severity of illness is higher.

For more:
- here's the study
- read the MedPage article
- check out the Hospitalist article

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