Over the past 13 years, medications and quality of care have been improving for heart failure patients in hospitals, experts say. An increasing number are surviving their hospital stay, which doctors say has been shortened by four days.
Though success inside the hospital is better, it’s when patients leave that there is a concern.
"At a time when we were focusing on shortening that length of stay, we might have been actually worsening some of the outcomes for patients,” said Dr. Harlan Krumholz, of the Yale University School of Medicine.
Those outcomes occurred within 30 days after patients left the hospital.
"What we found was that the risk of dying increased, the risk of needing to come back to the hospital because of worsening clinical conditions increased, the need for nursing home care increased. They were losing ground in this period, outcomes were worsening,” Krumholz said.
Krumholz and other researchers studied more than 6 million fee-for-service Medicare patients hospitalized for heart failure between 1993 and 2006.
“There was a 50 percent increase in sending people to nursing homes. Also, there was a marked increase in the amount of times people needed to come back to be re-hospitalized, so that was almost a 20 percent increase,” he said. "We didn't do so well over the last 14 years in improving the outcomes at that critical juncture.”
The study appears in the Journal of the American Medical Association.
Researchers say, going forward, it's important to look at all aspects of care, not just what happens to heart failure patients while they're hospitalized.