PMID- 23622909
OWN - NLM
STAT- MEDLINE
DCOM- 20130618
LR  - 20220408
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 165
IP  - 5
DP  - 2013 May
TI  - Access to heart failure care post emergency department visit: do we meet 
      established benchmarks and does it matter?
PG  - 725-32
LID - S0002-8703(13)00144-0 [pii]
LID - 10.1016/j.ahj.2013.02.017 [doi]
AB  - BACKGROUND: The Canadian Cardiology Society recommends that patients should be 
      seen within 2 weeks after an emergency department (ED) visit for heart failure 
      (HF). We sought to investigate whether patients who had an ED visit for HF 
      subsequently consult a physician within the current established benchmark, to 
      explore factors related to physician consultation, and to examine whether delay 
      in consultation is associated with adverse events (AEs) (death, hospitalization, 
      or repeat ED visit). METHODS: Patients were recruited by nurses at 8 hospital EDs 
      in Quebec, Canada, and interviewed by telephone within 6 weeks of discharge and 
      subsequently at 3 and 6 months. Clinical variables were extracted from medical 
      charts by nurses. We used Cox regression in the analysis. RESULTS: We enrolled 
      410 patients (mean age 74.9 +/- 11.1 years, 53% males) with a confirmed primary 
      diagnosis of HF. Only 30% consulted with a physician within 2 weeks post-ED 
      visit. By 4 weeks, 51% consulted a physician. Over the 6-month follow-up, 26% 
      returned to the ED, 25% were hospitalized, and 9% died. Patients who were 
      followed up within 4 weeks were more likely to be older and have higher education 
      and a worse quality of life. Patients who consulted a physician within 4 weeks of 
      ED discharge had a lower risk of AEs (hazard ratio 0.59, 95% CI 0.35-0.99). 
      CONCLUSION: Prompt follow-up post-ED visit for HF is associated with lower risk 
      for major AEs. Therefore, adherence to current HF guideline benchmarks for timely 
      follow-up post-ED visit is crucial.
CI  - Copyright (c) 2013 Mosby, Inc. All rights reserved.
FAU - Feldman, Debbie Ehrmann
AU  - Feldman DE
AD  - Universite de Montreal, Montreal, Quebec, Canada. debbie.feldman@umontreal.ca
FAU - Huynh, Thao
AU  - Huynh T
FAU - Lauriers, Julie Des
AU  - Lauriers JD
FAU - Giannetti, Nadia
AU  - Giannetti N
FAU - Frenette, Marc
AU  - Frenette M
FAU - Grondin, Francois
AU  - Grondin F
FAU - Michel, Caroline
AU  - Michel C
FAU - Sheppard, Richard
AU  - Sheppard R
FAU - Montigny, Martine
AU  - Montigny M
FAU - Lepage, Serge
AU  - Lepage S
FAU - Nguyen, Viviane
AU  - Nguyen V
FAU - Behlouli, Hassan
AU  - Behlouli H
FAU - Pilote, Louise
AU  - Pilote L
LA  - eng
GR  - Canadian Institutes of Health Research/Canada
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20130321
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
SB  - IM
MH  - Aged
MH  - *Benchmarking
MH  - Continuity of Patient Care/*standards
MH  - *Emergencies
MH  - Emergency Service, Hospital/*organization & administration
MH  - Female
MH  - Heart Failure/*therapy
MH  - Humans
MH  - Male
MH  - Office Visits/*statistics & numerical data
MH  - Quebec
EDAT- 2013/04/30 06:00
MHDA- 2013/06/19 06:00
CRDT- 2013/04/30 06:00
PHST- 2012/06/07 00:00 [received]
PHST- 2013/02/16 00:00 [accepted]
PHST- 2013/04/30 06:00 [entrez]
PHST- 2013/04/30 06:00 [pubmed]
PHST- 2013/06/19 06:00 [medline]
AID - S0002-8703(13)00144-0 [pii]
AID - 10.1016/j.ahj.2013.02.017 [doi]
PST - ppublish
SO  - Am Heart J. 2013 May;165(5):725-32. doi: 10.1016/j.ahj.2013.02.017. Epub 2013 Mar 
      21.