Discharge Processes and 30-Day Readmission Rates of Patients Hospitalized for Heart Failure on General Medicine and Cardiology Services

Am J Cardiol. 2018 May 1;121(9):1076-1080. doi: 10.1016/j.amjcard.2018.01.027. Epub 2018 Feb 7.


Given high rates of heart failure (HF) hospitalizations and widespread adoption of the hospitalist model, patients with HF are often cared for on General Medicine (GM) services. Differences in discharge processes and 30-day readmission rates between patients on GM and those on Cardiology during the contemporary hospitalist era are unknown. The present study compared discharge processes and 30-day readmission rates of patients with HF admitted on GM services and those on Cardiology services. We retrospectively studied 926 patients discharged home after HF hospitalization. The primary outcome was 30-day all-cause readmission after discharge from index hospitalization. Although 60% of patients with HF were admitted to Cardiology services, 40% were admitted to GM services. Prevalence of cardiovascular and noncardiovascular co-morbidities were similar between patients admitted to GM services and Cardiology services. Discharge summaries for patients on GM services were less likely to have reassessments of ejection fraction, new study results, weights, discharge vital signs, discharge physical examinations, and scheduled follow-up cardiologist appointments. In a multivariable regression analysis, patients on GM services were more likely to experience 30-day readmissions compared with those on Cardiology services (odds ratio 1.43 95% confidence interval [1.05 to 1.96], p = 0.02). In conclusion, outcomes are better among those admitted to Cardiology services, signaling the need for studies and interventions focusing on noncardiology hospital providers that care for patients with HF.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cardiology Service, Hospital
  • Female
  • Heart Failure / diagnosis
  • Heart Failure / epidemiology
  • Heart Failure / therapy*
  • Hospitalization / statistics & numerical data*
  • Humans
  • Internal Medicine / standards*
  • Internal Medicine / trends
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Outcome Assessment, Health Care*
  • Patient Discharge / standards*
  • Patient Discharge / trends
  • Patient Readmission / statistics & numerical data*
  • Retrospective Studies
  • Risk Assessment
  • Statistics, Nonparametric
  • Treatment Outcome
  • United States