Faktor yang Mempengaruhi Kejadian Readmisi 30 Hari terhadap Pasien Congestive Heart Failure (CHF)
Abstract
This study aimed to identify the literature exploring the relationship between LACE scores (length of stay, acuity of admission, comorbidities and number of emergency room visits in the past six months) and health care costs for unplanned hospitalizations within 30 days of discharge, as well as the completeness of administrative data from the status of hospital medical records. The research method uses a literature review by tracing the results of publications between 2017-2020. The databases used were PubMed, ScienceDirect and ProQuest, with the results of 76 articles. The results identified eight studies that met the inclusion criteria and resulted in significant improvements using the LACE score in assessing and preventing readmission and lowering hospital costs. In conclusion, a predictor device application that uses electronic data or medical records is needed to manage CHF patients' readmissions. The use of the LACE score has the potential to aid clinical decisions as well as prevent future hospital readmissions. The higher the LACE score, the higher the readmission of CHF patients for 30 days, resulting in higher hospital costs.
Keywords: Hospital Costs, Congestive Heart Failure, LACE Score
References
Amin, A. N. (2019). Costs Associated with Unplanned Readmissions among Patients with Heart Failure with and without Hyponatremia. American Journal of Health-System Pharmacy, 76(6), 374–380. https://doi.org/10.1093/ajhp/zxy064
Bunting, K. V., Gill, S. K., Sitch, A., Mehta, S., O’Connor, K., Lip, G. Y. H., Kirchhof, P., Strauss, V., Rahimi, K., Camm, A. J., Stanbury, M., Griffith, M., Townend, J. M., Gkoutos, G. V., Karwath, A., Steeds, R. P., & Kotecha, D. (2021). Improving the Diagnosis of Heart Failure in Patients with Atrial Fibrillation. Heart, 107, 902–908. https://doi.org/10.1136/heartjnl-2020-318557
Chaiyachati, K. H., Qi, M., & Werner, R. M. (2018). Changes to Racial Disparities in Readmission Rates After Medicare’s Hospital Readmissions Reduction Program Within Safety-Net and Non-Safety-Net Hospitals. JAMA Network Open, 1(7), 1-12. https://doi.org/10.1001/jamanetworkopen.2018.4154
Chen, C., Li, X., Sun, L., Cao, S., Kang, Y., Hong, L., Liang, Y., You, G., & Zhang, Q. (2019). Post-Discharge Short Message Service Improves Short-Term Clinical Outcome and Self-Care Behaviour in Chronic Heart Failure. ESC Heart Failure, 6(1), 164–173. https://doi.org/10.1002/ehf2.12380
Cornelis, J., & Myers, J. (2018). Exercise Training in Heart Failure Patients with Persistent Atrial Fibrillation: A Practical Approach. Cardiac Failure Review, 4(2), 107-111. https://doi.org/10.15420/cfr.2018.19.2
Damery, S., & Combes, G. (2017). Evaluating the Predictive Strength of the LACE Index in Identifying Patients at High Risk of Hospital Readmission Following an Inpatient Episode: A Retrospective Cohort Study. BMJ Open, 7(7), 1–8. https://doi.org/10.1136/bmjopen-2017-016921
Inampudi, C., Akintoye, E., Bengaluru Jayanna, M., Asleh, R., Briasouli, A., Alvarez, P., & Briasoulis, A. (2019). Trends in In-Hospital Mortality, Length of Stay, Nonroutine Discharge, and Cost Among End-Stage Renal Disease Patients on Dialysis Hospitalized with Heart Failure (2001–2014). Journal of Cardiac Failure, 25(7), 524-533. https://doi.org/10.1016/j.cardfail.2019.02.020
Kementerian Kesehatan Republik Indonesia. (2018). Riset Kesehatan Dasar. https://kesmas.kemkes.go.id/assets/upload/dir_519d41d8cd98f00/files/Hasil-riskesdas-2018_1274.pdf
Kim, L. K., Yeo, I., Cheung, J. W., Swaminathan, R. V., Wong, S. C., Charitakis, K., Adejumo, O., Chae, J., Minutello, R. M., Bergman, G., Singh H., & Feldman, D. N. (2018). Thirty-Day Readmission Rates, Timing, Causes, and Costs after St Segment-Elevation Myocardial Infarction in the United States: A National Readmission Database Analysis 2010-2014. Journal of the American Heart Association, 7(18), 1-34. https://doi.org/10.1161/JAHA.118.009863
Konstam, M. A., Kiernan, M. S., Bernstein, D., Bozkurt, B., Jacob, M., Kapur, N. K., Kociol, R. D., Lewis, E. F., Mehra, M. R., Pagani, F. D., Raval, A. N., & Ward, C. (2018). Evaluation and Management of Right-Sided Heart Failure: A Scientific Statement from the American Heart Association. Circulation, 137(20), 578-622. https://doi.org/10.1161/cir.0000000000000560
Kramer, T., Vogler, C., Robinson, R., & Bhattarai, M. (2020). Readmission Rates and Medication Selection for Patients with Heart Failure Preserved Ejection Fraction. MedRxiv, 1–15. https://doi.org/10.1101/2020.07.29.20163956
Kripalani, S., Chen, G., Ciampa, P., Theobald, C., Cao, A., McBride, M., Dittus, R. S., & Speroff, T. (2019). A Transition Care Coordinator Model Reduces Hospital Readmissions and Costs. Contemporary Clinical Trials, 81, 55–61. https://doi.org/10.1016/j.cct.2019.04.014
Kurtz, S. M., Lau, E., Baykal, D., Odum, S. M., Springer, B. D., & Fehring, T. K. (2019). Are Ceramic Bearings Becoming Cost-Effective for All Patients within a 90-Day Bundled Payment Period? Journal of Arthroplasty, 34(6), 1082–1088. https://doi.org/10.1016/j.arth.2019.01.074
Li, J., Li, Q., Shen, Y., Zhang, L., Zhang, C., Guo, T., & Guo, Z. (2020). Pleural Effusion and Acute Right Heart Failure Due to a Ruptured Right Sinus of Valsalva Aneurysm and Correction by Surgical Intervention. Journal of Cardiovascular and Thoracic Research, 12(2), 150–151. https://doi.org/10.34172/jcvtr.2020.25
Lim, N., Eun, S., Lee, H., Cho, H., Choe, W., Kim, H., Choi, J. O., Jeon, E. S., Kim, M. S., Kim, J. J., Hwang, K. K., Chae, S. C., Baek, S. H., Kang, S. M., Choi, D. J., Yoo, B. S., Kim, K. H., Cho, M. C., Oh, B. H., & Park, H. Y. (2018). Risk Prediction for 30-Day Heart Failure-Specific Readmission or Death After Discharge : Data from the Korean Acute Heart Failure (Korahf) Registry. Journal of Cardiology, 73(2), 108-113. https://doi.org/10.1016/j.jjcc.2018.07.009
Low, L. L., Liu, N., Lee, K. H., Ong, M. E. H., Wang, S., Jing, X., & Thumboo, J. (2017). FAM-FACE-SG: A Score for Risk Stratification of Frequent Hospital Admitters. BMC Medical Informatics and Decision Making, 17(1), 1–12. https://doi.org/10.1186/s12911-017-0441-5
McAlister, F. A., Youngson, E., & Kaul, P. (2017). Patients with Heart Failure Readmitted to the Original Hospital have Better Outcomes than those Readmitted Elsewhere. Journal of the American Heart Association, 6(5), 1–7. https://doi.org/10.1161/JAHA.116.004892
Miller, W. D., Nguyen, K., Vangala, S., & Dowling, E. (2018). Clinicians Can Independently Predict 30-Day Hospital Readmissions as well as the LACE Index. BMC Health Services Research, 18(1), 1–6. https://doi.org/10.1186/s12913-018-2833-3
Mirkin, K. A., Enomoto, L. M., Caputo, G. M., & Hollenbeak, C. S. (2017). Risk Factors for 30-Day Readmission in Patients with Congestive Heart Failure. Heart and Lung: Journal of Acute and Critical Care, 46(5), 357–362. https://doi.org/10.1016/j.hrtlng.2017.06.005
Moertl, D., Altenberger, J., Bauer, N., Berent, R., Berger, R., Boehmer, A., Ebner, C., Fritsch, M., Geyrhofer, F., Huelsmann, M., Poelzl, G., & Stefenelli, T. (2017). Disease Management Programs in Chronic Heart Failure Position Statement of the Heart Failure Working Group and the Working Group of the Cardiological Assistance and Care Personnel of the Austrian Society of Cardiology. Wien Klin Wochenschr, 129(23-24), 869-878. https://doi.org/10.1007/s00508-017-1265-0
Mueller, C., Bally, K., Buser, M., Flammer, A. J., Gaspoz, J. M., Mach, F., Moschovitis, G., Paul, M., Zeller, A., Heitlinger, E., Fay, B., & Rosemann, T. (2020). Roadmap for the Treatment of Heart Failure Patients after Hospital Discharge: An Interdisciplinary Consensus Paper. Swiss Medical Weekly, 150, 1-9. https://doi.org/10.4414/smw.2020.20159
Nair, R., Lak, H., Hasan, S., Gunasekaran, D., Babar, A., & Gopalakrishna, K. V. (2020). Reducing All-Cause 30-Day Hospital Readmissions for Patients Presenting with Acute Heart Failure Exacerbations: A Quality Improvement Initiative. Cureus, 12(3), 10–14. https://doi.org/10.7759/cureus.7420
Rådholm, K., Figtree, G., Perkovic, V., Solomon, S. D., Mahaffey, K. W., De Zeeuw, D., Fulcher, G., Barrett, T. D., Shaw, W., Desai, M., Matthews, D. R., & Neal, B. (2018). Canagliflozin and Heart Failure in Type 2 Diabetes Mellitus: Results from the CANVAS Program. Circulation, 138(5), 458–468. https://doi.org/10.1161/CIRCULATIONAHA.118.034222
Taklalsingh, N., Wengrofsky, P., & Levitt, H. (2020). The Heart Failure Clinic: Improving 30-Day All-Cause Hospital Readmissions. Journal for Healthcare Quality, 42(4), 215–223. https://doi.org/10.1097/JHQ.0000000000000221
Tomoaia, R., Beyer, R. S., Simu, G., Serban, A. M., & Pop, D. (2019). Understanding the Role of Echocardiography in Remodeling after Acute Myocardial Infarction and Development of Heart Failure with Preserved Ejection Fraction. Medical Ultrasonography, 21(1), 69–76. https://doi.org/10.11152/mu-1768
Van de Wouw, J., Broekhuizen, M., Sorop, O., Joles, J. A., Verhaar, M. C., Duncker, D. J., Danser, A. H. J., & Merkus, D. (2019). Chronic Kidney Disease as a Risk Factor for Heart Failure with Preserved Ejection Fraction: A Focus on Microcirculatory Factors and Therapeutic Targets. Frontiers in Physiology, 10, 1-16. https://doi.org/10.3389/fphys.2019.01108
Vasilevskis, E. E., Ouslander, J. G., Mixon, A. S., Bell, S. P., Jacobsen, J. M. Lou, Saraf, A. A., Markley, D., Sponsler, K. C., Shutes, J., Long, E. A., Kripalani, S., Simmons, S. F., & Schnelle, J. F. (2017). Potentially Avoidable Readmissions of Patients Discharged to Post-Acute Care: Perspectives of Hospital and Skilled Nursing Facility Staff. Journal of the American Geriatrics Society, 65(2), 269–276. https://doi.org/10.1111/jgs.14557
Verulava, T., Jorbenadze, R., Lordkipanidze, A., Gongadze, A., Tsverava, M., & Donjashvili, M. (2021). Readmission after Hospitalization for Heart Failure in Elderly Patients in Chapidze Emergency Cardiology Center, Georgia. Journal of Health Research, 1-9. https://doi.org/10.1108/jhr-07-2020-0294
Bunting, K. V., Gill, S. K., Sitch, A., Mehta, S., O’Connor, K., Lip, G. Y. H., Kirchhof, P., Strauss, V., Rahimi, K., Camm, A. J., Stanbury, M., Griffith, M., Townend, J. M., Gkoutos, G. V., Karwath, A., Steeds, R. P., & Kotecha, D. (2021). Improving the Diagnosis of Heart Failure in Patients with Atrial Fibrillation. Heart, 107, 902–908. https://doi.org/10.1136/heartjnl-2020-318557
Chaiyachati, K. H., Qi, M., & Werner, R. M. (2018). Changes to Racial Disparities in Readmission Rates After Medicare’s Hospital Readmissions Reduction Program Within Safety-Net and Non-Safety-Net Hospitals. JAMA Network Open, 1(7), 1-12. https://doi.org/10.1001/jamanetworkopen.2018.4154
Chen, C., Li, X., Sun, L., Cao, S., Kang, Y., Hong, L., Liang, Y., You, G., & Zhang, Q. (2019). Post-Discharge Short Message Service Improves Short-Term Clinical Outcome and Self-Care Behaviour in Chronic Heart Failure. ESC Heart Failure, 6(1), 164–173. https://doi.org/10.1002/ehf2.12380
Cornelis, J., & Myers, J. (2018). Exercise Training in Heart Failure Patients with Persistent Atrial Fibrillation: A Practical Approach. Cardiac Failure Review, 4(2), 107-111. https://doi.org/10.15420/cfr.2018.19.2
Damery, S., & Combes, G. (2017). Evaluating the Predictive Strength of the LACE Index in Identifying Patients at High Risk of Hospital Readmission Following an Inpatient Episode: A Retrospective Cohort Study. BMJ Open, 7(7), 1–8. https://doi.org/10.1136/bmjopen-2017-016921
Inampudi, C., Akintoye, E., Bengaluru Jayanna, M., Asleh, R., Briasouli, A., Alvarez, P., & Briasoulis, A. (2019). Trends in In-Hospital Mortality, Length of Stay, Nonroutine Discharge, and Cost Among End-Stage Renal Disease Patients on Dialysis Hospitalized with Heart Failure (2001–2014). Journal of Cardiac Failure, 25(7), 524-533. https://doi.org/10.1016/j.cardfail.2019.02.020
Kementerian Kesehatan Republik Indonesia. (2018). Riset Kesehatan Dasar. https://kesmas.kemkes.go.id/assets/upload/dir_519d41d8cd98f00/files/Hasil-riskesdas-2018_1274.pdf
Kim, L. K., Yeo, I., Cheung, J. W., Swaminathan, R. V., Wong, S. C., Charitakis, K., Adejumo, O., Chae, J., Minutello, R. M., Bergman, G., Singh H., & Feldman, D. N. (2018). Thirty-Day Readmission Rates, Timing, Causes, and Costs after St Segment-Elevation Myocardial Infarction in the United States: A National Readmission Database Analysis 2010-2014. Journal of the American Heart Association, 7(18), 1-34. https://doi.org/10.1161/JAHA.118.009863
Konstam, M. A., Kiernan, M. S., Bernstein, D., Bozkurt, B., Jacob, M., Kapur, N. K., Kociol, R. D., Lewis, E. F., Mehra, M. R., Pagani, F. D., Raval, A. N., & Ward, C. (2018). Evaluation and Management of Right-Sided Heart Failure: A Scientific Statement from the American Heart Association. Circulation, 137(20), 578-622. https://doi.org/10.1161/cir.0000000000000560
Kramer, T., Vogler, C., Robinson, R., & Bhattarai, M. (2020). Readmission Rates and Medication Selection for Patients with Heart Failure Preserved Ejection Fraction. MedRxiv, 1–15. https://doi.org/10.1101/2020.07.29.20163956
Kripalani, S., Chen, G., Ciampa, P., Theobald, C., Cao, A., McBride, M., Dittus, R. S., & Speroff, T. (2019). A Transition Care Coordinator Model Reduces Hospital Readmissions and Costs. Contemporary Clinical Trials, 81, 55–61. https://doi.org/10.1016/j.cct.2019.04.014
Kurtz, S. M., Lau, E., Baykal, D., Odum, S. M., Springer, B. D., & Fehring, T. K. (2019). Are Ceramic Bearings Becoming Cost-Effective for All Patients within a 90-Day Bundled Payment Period? Journal of Arthroplasty, 34(6), 1082–1088. https://doi.org/10.1016/j.arth.2019.01.074
Li, J., Li, Q., Shen, Y., Zhang, L., Zhang, C., Guo, T., & Guo, Z. (2020). Pleural Effusion and Acute Right Heart Failure Due to a Ruptured Right Sinus of Valsalva Aneurysm and Correction by Surgical Intervention. Journal of Cardiovascular and Thoracic Research, 12(2), 150–151. https://doi.org/10.34172/jcvtr.2020.25
Lim, N., Eun, S., Lee, H., Cho, H., Choe, W., Kim, H., Choi, J. O., Jeon, E. S., Kim, M. S., Kim, J. J., Hwang, K. K., Chae, S. C., Baek, S. H., Kang, S. M., Choi, D. J., Yoo, B. S., Kim, K. H., Cho, M. C., Oh, B. H., & Park, H. Y. (2018). Risk Prediction for 30-Day Heart Failure-Specific Readmission or Death After Discharge : Data from the Korean Acute Heart Failure (Korahf) Registry. Journal of Cardiology, 73(2), 108-113. https://doi.org/10.1016/j.jjcc.2018.07.009
Low, L. L., Liu, N., Lee, K. H., Ong, M. E. H., Wang, S., Jing, X., & Thumboo, J. (2017). FAM-FACE-SG: A Score for Risk Stratification of Frequent Hospital Admitters. BMC Medical Informatics and Decision Making, 17(1), 1–12. https://doi.org/10.1186/s12911-017-0441-5
McAlister, F. A., Youngson, E., & Kaul, P. (2017). Patients with Heart Failure Readmitted to the Original Hospital have Better Outcomes than those Readmitted Elsewhere. Journal of the American Heart Association, 6(5), 1–7. https://doi.org/10.1161/JAHA.116.004892
Miller, W. D., Nguyen, K., Vangala, S., & Dowling, E. (2018). Clinicians Can Independently Predict 30-Day Hospital Readmissions as well as the LACE Index. BMC Health Services Research, 18(1), 1–6. https://doi.org/10.1186/s12913-018-2833-3
Mirkin, K. A., Enomoto, L. M., Caputo, G. M., & Hollenbeak, C. S. (2017). Risk Factors for 30-Day Readmission in Patients with Congestive Heart Failure. Heart and Lung: Journal of Acute and Critical Care, 46(5), 357–362. https://doi.org/10.1016/j.hrtlng.2017.06.005
Moertl, D., Altenberger, J., Bauer, N., Berent, R., Berger, R., Boehmer, A., Ebner, C., Fritsch, M., Geyrhofer, F., Huelsmann, M., Poelzl, G., & Stefenelli, T. (2017). Disease Management Programs in Chronic Heart Failure Position Statement of the Heart Failure Working Group and the Working Group of the Cardiological Assistance and Care Personnel of the Austrian Society of Cardiology. Wien Klin Wochenschr, 129(23-24), 869-878. https://doi.org/10.1007/s00508-017-1265-0
Mueller, C., Bally, K., Buser, M., Flammer, A. J., Gaspoz, J. M., Mach, F., Moschovitis, G., Paul, M., Zeller, A., Heitlinger, E., Fay, B., & Rosemann, T. (2020). Roadmap for the Treatment of Heart Failure Patients after Hospital Discharge: An Interdisciplinary Consensus Paper. Swiss Medical Weekly, 150, 1-9. https://doi.org/10.4414/smw.2020.20159
Nair, R., Lak, H., Hasan, S., Gunasekaran, D., Babar, A., & Gopalakrishna, K. V. (2020). Reducing All-Cause 30-Day Hospital Readmissions for Patients Presenting with Acute Heart Failure Exacerbations: A Quality Improvement Initiative. Cureus, 12(3), 10–14. https://doi.org/10.7759/cureus.7420
Rådholm, K., Figtree, G., Perkovic, V., Solomon, S. D., Mahaffey, K. W., De Zeeuw, D., Fulcher, G., Barrett, T. D., Shaw, W., Desai, M., Matthews, D. R., & Neal, B. (2018). Canagliflozin and Heart Failure in Type 2 Diabetes Mellitus: Results from the CANVAS Program. Circulation, 138(5), 458–468. https://doi.org/10.1161/CIRCULATIONAHA.118.034222
Taklalsingh, N., Wengrofsky, P., & Levitt, H. (2020). The Heart Failure Clinic: Improving 30-Day All-Cause Hospital Readmissions. Journal for Healthcare Quality, 42(4), 215–223. https://doi.org/10.1097/JHQ.0000000000000221
Tomoaia, R., Beyer, R. S., Simu, G., Serban, A. M., & Pop, D. (2019). Understanding the Role of Echocardiography in Remodeling after Acute Myocardial Infarction and Development of Heart Failure with Preserved Ejection Fraction. Medical Ultrasonography, 21(1), 69–76. https://doi.org/10.11152/mu-1768
Van de Wouw, J., Broekhuizen, M., Sorop, O., Joles, J. A., Verhaar, M. C., Duncker, D. J., Danser, A. H. J., & Merkus, D. (2019). Chronic Kidney Disease as a Risk Factor for Heart Failure with Preserved Ejection Fraction: A Focus on Microcirculatory Factors and Therapeutic Targets. Frontiers in Physiology, 10, 1-16. https://doi.org/10.3389/fphys.2019.01108
Vasilevskis, E. E., Ouslander, J. G., Mixon, A. S., Bell, S. P., Jacobsen, J. M. Lou, Saraf, A. A., Markley, D., Sponsler, K. C., Shutes, J., Long, E. A., Kripalani, S., Simmons, S. F., & Schnelle, J. F. (2017). Potentially Avoidable Readmissions of Patients Discharged to Post-Acute Care: Perspectives of Hospital and Skilled Nursing Facility Staff. Journal of the American Geriatrics Society, 65(2), 269–276. https://doi.org/10.1111/jgs.14557
Verulava, T., Jorbenadze, R., Lordkipanidze, A., Gongadze, A., Tsverava, M., & Donjashvili, M. (2021). Readmission after Hospitalization for Heart Failure in Elderly Patients in Chapidze Emergency Cardiology Center, Georgia. Journal of Health Research, 1-9. https://doi.org/10.1108/jhr-07-2020-0294
