2 Adamson et al 30-Day Readmissions in PA Pressure – Guided HF Care

Heart failure (HF) is a chronic, progressive disorder affecting over 5 million patients in the United States and an estimated 26 million worldwide, with clearly higher prevalence in elderly populations. Patients with HF frequently experience worsening symptoms related to accumulation of excess intravascular volume and congestion, which may trigger hospitalization to provide intravenous medical support to restore normal volume. As a result, HF is cited as the most frequent principal diagnosis, resulting in over 1 million admissions per year (1%–2% of all hospitalizations) in the United States. The economic impact of HF on national healthcare systems is profound, with the total costs of HF in the United States estimated to increase from $31 billion in 2012 to $70 billion in 2030, secondary to an aging population with nearly 80% of costs attributed to hospitalizations alone. Readmissions to the hospital shortly after a patient being treated for HF is discharged are identified by the Center for Medicare & Medicaid Services as potentially preventable events. In an effort to reduce preventable readmission rates and improve quality of care while decreasing costs, the Affordable Care Act established the Hospital Readmissions Reduction Program. The Hospital Readmissions Reduction Program requires Center for Medicare & Medicaid Services to reduce payments to inpatient prospective payment system hospitals with excess readmissions for priority conditions, including HF. Any hospitalization that occurs within 30 days after a HF admission is counted and can result from a variety of disorders. When HF is the reason for readmission, the primary cause is rapid recongestion and the return of patient symptoms. In the CardioMicroelectromechanical system (Cardio MEMS) Heart Sensor Allows Monitoring of Pressures to Improve Outcomes in New York Heart Association Class Original Article