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Home care cuts mortality and readmission for heart failure

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Home-based treatment provided by nurses is a viable alternative to hospital care for heart patients, according to Australian researchers.

A study has suggested that post-discharge disease management provided at home could be a cost-effective alternative for recently-hospitalised elderly patients with chronic heart failure.

“The net benefit of home-based intervention appeared to be pronounced among the patients with a low level of self-care confidence or with fewer co-existing diseases”

Shoko Maru

It showed that specialist home care could both reduce mortality and readmissions to hospital among heart failure patients.

The study, a collaboration between Griffith University in Queensland and the Australian Catholic University in Melbourne, involved data on 280 patients at public sector hospitals.

It compared a home-based intervention delivered by specialist nurses and community-based health professionals – GPs and community pharmacists – versus the traditional clinic-based intervention delivered by a specialist clinic based in the hospital.

Intervention was provided for up to 1.5 years with median follow-up of 3.2 years.

The groups were compared in terms of total healthcare costs and quality-adjusted life-years – years of life adjusted for their quality.

“Compared with clinic-based intervention, home-based intervention is likely to be cost-effective in elderly CHF patients with significant comorbidity,” said the researchers in the International Journal of Cardiology.

Lead study author Dr Shoko Maru said a range of analysis techniques had “converged on a common conclusion” that the home-based intervention was “likely to be cost-effective”.

“The net benefit of home-based intervention appeared to be pronounced among the patients with a low level of self-care confidence or with fewer co-existing diseases,” she said.

Dr Maru said those in the home-based group lived longer and when they did require readmission their hospital stay was shorter.

She added: “Our findings inform the long-term cost-effectiveness of intervention intended for a lifelong disease such as chronic heart failure.”

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