Objective:

To evaluate the association of an acute hospital care at home program for acute heart failure with readmission, mortality, and guideline-directed medical therapy (GDMT) utilization after discharge.

Approach:

• Study Design: Retrospective cohort study based on data from Kaiser Permanente Southern California (KPSC) focusing on patients hospitalized for acute heart failure.
• Program Overview: The KPSC advanced medical care at home (AMCAH) program provides hospital-level care at home, including mobile phlebotomy, intravenous medication administration, nursing visits, and remote monitoring.
• Cohort Selection: Patients were selected from an existing database of adult members hospitalized for acute heart failure, with specific exclusion criteria applied.
• Comparative Analysis: Intra- and inter-service area comparisons were made between patients discharged from AMCAH and those from traditional brick-and-mortar (BAM) hospitals.

Key Findings:

• Acute heart failure accounts for 4.1% of all hospitalizations in the US.
• The prevalence of heart failure is expected to affect 8 million people in the US by 2030.
• Concerns regarding patient safety and quality metrics specific to heart failure in home care settings remain.

Interpretation:

Ongoing evaluation of safety and quality in acute hospital care at home is necessary to refine processes before scaling.

Limitations:

• Limited contemporary evidence specific to heart failure within the US.
• Concerns regarding patient safety and quality metrics specific to heart failure care at home.

Conclusion:

The study aims to evaluate the association of an acute hospital care at home program for acute heart failure with readmission, mortality, and guideline-directed medical therapy utilization after discharge.

Sources:

• Kaiser Permanente Southern California