P017. Impact of Chronic Care Management on Heart Failure Readmissions

Abstract

Background Heart Failure (HF) currently affects 6.2 million Americans, with an expected 8.5 million by 2030. There are 134, 000 annual HF readmissions (CMS) at an estimated cost of $4.5 billion. HF readmission significantly impacts Quality of Life (QOL) and mortality. Research suggests that Chronic Care Management (CCM) programs improve patient outcomes and reduce healthcare costs. Given the significant clinical and economic burdens associated with HF, we examined the effect of Nurse Practitioner led CCM program on hospitalization rate in HF patients. Method All patients enrolled in the CCM program between May 31, 2017 and January 4, 2019 at the Advanced Heart Disease Clinic were included in the analysis. Criteria for CCM participation included a diagnosis of HF plus another chronic condition. Number of hospitalizations, KCCQ scores, and LVEF scores were collected on each patient during the 18-month period, pre-enrollment and post-enrollment. A non-parametric Wilcox Signed-Rank Test was used to compare hospitalization rate; a Paired Sample T-test was used to compare QOL and LVEF. Results Twenty-nine patients were included in the analysis. Post CCM enrollment, there was a statistically significant reduction in HF hospitalization compared to pre-enrollment (p= 0.0007; 95% CL). Among the 14 (48%) patients with available KCCQ scores, no statistical difference was found pre to post-enrollment. Among the 25 (86.2%) patients with documented LVEF scores, 48% had improved EFs post enrollment (p=0.20). These results indicated that enrollment in a CCM program for HF may significantly reduce hospitalizations and in turn may have a positive impact on QOL with improvement in LVEF.