Heart Failure Patients Do Worse in Nursing Homes

Medicare patients discharged from the hospital and released to a <"http://www.yourlawyer.com/practice_areas/nursing_home_negligence">nursing home are likelier to be hospitalized again or to die within one year, versus patients released to their homes, according to Internal Medicine News. The findings are from a large observational study of over 15,400 patients and 149 hospitals.

Even after adjustments were made for a number of demographic- and health-related factors, a strong link to death—79%—remained in patients released to a skilled nursing facility, according to Dr. Allen of the Colorado Cardiovascular Outcomes Research Consortium, University of Colorado Denver in Aurora, Colorado, said Internal Medicine News. The study found that the rate remained even after taking into account a broad number of so-called “patient factors” that are typically linked to adverse reactions, according to the team, said Internal Medicine News.

Patients involved in the study—15,459 adults—were aged 65 and older with a median age of 80, and who were released to a “skilled nursing facility (24.1%), home with home health service (22.3%), or home with self-care (53.6%),” said Internal Medicine News. All of the patients were hospitalized for heart failure for no less than three days—and for a median of 5 days—sometime between 2005-2006. The patients were all registered participants with the Get With The Guidelines—Heart Failure Program, which is “an ongoing, voluntary quality-improvement initiative of the American Heart Association,” wrote Internal Medicine News.

The factors connected to discharge to a facility were longer hospital stays, advanced age, being female, elevated systolic blood pressure, a left ventricular ejection fraction less than 40%, elevated sodium level; and history of hyperlipidemia, anemia, diabetes, valvular heart disease, myocardial infarction, bypass surgery, percutaneous coronary intervention, implantable defibrillator, depression, stroke, peripheral vascular disease, or chronic obstructive pulmonary disease or asthma, said Internal Medicine News.

Nationwide, the discharge rate to facilities was highest in the northeast at 30% and lowest in the West at 23.6%; also hospitals treating more racial minority and younger patients saw the lowest discharges to a facility, Internal Medicine News noted.

We have long been reporting on persistent tragedy of nursing home abuse in which beatings, sexual abuse, chemical restraints, and negligence—to name just some—have led to nursing home closures; probes; and lawsuits, both individual and class action. One recent class action verdict in a negligence case involved 32,000 patients at 22 facilities.

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