Hospital Stays Shorter for Heart Failure
Study Shows Hospital Readmissions and Admissions to Nursing Homes Are Up
Longer Stays Not the Answer
But that doesn't mean patients are better off when they are hospitalized longer, he adds.
"Hospitals can be dangerous places, especially for older patients who are most at risk for life-threatening infections," he says. "People should be hospitalized only as long as they need to be, but there has to be a plan for treating them after discharge."
Philadelphia heart failure specialist Alfred A. Bove, MD, who is immediate past president of the American College of Cardiology (ACC), agrees that the lack of continuity of care following hospitalization is a bigger contributor to poor outcomes than shorter hospital stays.
"Heart failure patients can certainly be managed outside the hospital, but it requires a level of care that they have not been getting," he says.
These days, he says, most patients are discharged with no plan for follow-up care.
The ACC recently launched a nationwide program to address this problem that includes 725 institutions. The goal, he says, is to reduce unnecessary hospital readmissions by 20% by 2013.
Health Care Reform May Help
A provision of the new health care reform law set to go into effect in 2012 has provisions that are designed to penalize hospitals with high readmission rates.
Krumholz says the details are still being worked out, but the idea is to give hospitals an economic incentive to provide care after discharge.
A billion dollars in last year's federal economic stimulus plan has also been earmarked for tracking the influence of in-hospital practices, such as length of stay, on patient outcomes, San Francisco public health director Mitchell Katz, MD, tells WebMD.
"The impact of shorter or longer hospital stays on quality of life hasn't been well understood, but that may soon change," he says.