PMID- 15494772
OWN - NLM
STAT- MEDLINE
DCOM- 20041210
LR  - 20191210
IS  - 0828-282X (Print)
IS  - 0828-282X (Linking)
VI  - 20
IP  - 12
DP  - 2004 Oct
TI  - Multidisciplinary outpatient congestive heart failure clinic: impact on hospital 
      admissions and emergency room visits.
PG  - 1205-11
AB  - BACKGROUND: Life-saving drugs, such as angiotensin-converting enzyme inhibitors 
      and beta-blockers, are frequently underused and underdosed in patients with heart 
      failure. Specialized clinics have been shown to provide additional benefits. 
      OBJECTIVES: To determine the impact of a multidisciplinary outpatient heart 
      failure clinic on the frequency of cardiovascular readmissions and emergency room 
      (ER) visits, length of inpatient and ER stays, and New York Heart Association 
      (NYHA) class. METHODS: A retrospective chart review study comprising 72 patients 
      who had two or more visits to a heart failure clinic between December 1, 1998, 
      and August 31, 1999, was performed. The number of readmissions and ER visits, and 
      the NYHA class were recorded during the six-month period before and after the 
      first visit to the clinic. RESULTS: Most subjects were in NYHA class III or IV 
      (71% and 21%, respectively), and the mean ejection fraction was 31%. The post- 
      versus preintervention relative risk of readmission was 0.43 (95% CI 0.25 to 
      0.72). The total number of inpatient days decreased by 54% (95% CI 44% to 62%). 
      The post- versus preintervention relative risk of an ER visit was 0.29 (95% CI 
      0.19 to 0.45). The number of ER days decreased by 60% (95% CI 41% to 73%). NYHA 
      functional class significantly improved, with most subjects ending the six-month 
      postintervention period in class I or II (33% and 49%, respectively; P=0.001). 
      CONCLUSIONS: This multidisciplinary heart failure clinic significantly decreased 
      the risk of cardiovascular readmissions and subsequent ER visits. It led to 
      improvement in NYHA class and to a decrease in the number of days spent in the 
      hospital and in the ER.
FAU - Martineau, Pierre
AU  - Martineau P
AD  - Hopital du Sacre-Coeur de Montreal and Faculte de Pharmacie, Universite de 
      Montreal, Montreal, Quebec, Canada.
FAU - Frenette, Marc
AU  - Frenette M
FAU - Blais, Lucie
AU  - Blais L
FAU - Sauve, Claude
AU  - Sauve C
LA  - eng
PT  - Comparative Study
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Can J Cardiol
JT  - The Canadian journal of cardiology
JID - 8510280
RN  - 0 (Cardiotonic Agents)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Ambulatory Care Facilities/*standards/statistics & numerical data
MH  - Cardiotonic Agents/administration & dosage/therapeutic use
MH  - Emergency Service, Hospital/*statistics & numerical data
MH  - Female
MH  - Health Services Research
MH  - Heart Failure/diagnosis/*drug therapy/mortality
MH  - Hospitalization/*statistics & numerical data
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Patient Readmission/statistics & numerical data
MH  - Probability
MH  - Prognosis
MH  - Quebec/epidemiology
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Severity of Illness Index
MH  - Survival Rate
MH  - Total Quality Management
MH  - Treatment Outcome
MH  - Utilization Review
EDAT- 2004/10/21 09:00
MHDA- 2004/12/16 09:00
CRDT- 2004/10/21 09:00
PHST- 2004/10/21 09:00 [pubmed]
PHST- 2004/12/16 09:00 [medline]
PHST- 2004/10/21 09:00 [entrez]
PST - ppublish
SO  - Can J Cardiol. 2004 Oct;20(12):1205-11.