Physician Continuity Improves Heart Failure Outcomes
(HealthDay News) – Both early physician follow-up and continuity of physician care following an initial hospital diagnosis of heart failure improve patient outcomes, according to research published online Aug. 19 in CMAJ, the journal of the Canadian Medical Association.
Finlay A. McAlister MD, from the University of Alberta in Edmonton, Canada, and colleagues analyzed data from linked administrative databases for all adults (aged ≥20 years) in the province of Alberta who were discharged alive from hospital (from January 1999–June 2009) with a first-time diagnosis of heart failure (24,373 patients). A physician who had seen the patient at least twice in the year before the index admission or once during the index admission was defined as familiar.
The researchers found that 21.9% of the patients (5,336) had no follow-up visits, 69.2% saw a familiar physician (16,855), and 9% saw unfamiliar physicians exclusively (2,182). Among patients who saw a familiar physician or an unfamiliar physician, the risk of death or unplanned readmission during the six-month observation period was lower (adjusted hazard ratio [HR], 0.87 and 0.9, respectively) compared to that seen in patients who had no follow-up visits. The risk of death or urgent readmission was lower among patients who had all of their visits with a familiar physician, compared to those followed by unfamiliar physicians, over the six-month period (adjusted HR, 0.91).
"Early physician follow-up after discharge and physician continuity were both associated with better outcomes among patients with heart failure," the authors write.