Assessing heart care failure is more dependent on how well hospitals adhere to treatment guidelines for heart failure than comparing patient volumes at hospitals, reports new study. While volume alone didn't make much difference to mortality or readmission rates, hospitals seeing fewer heart failure patients were "significantly" less likely to follow American Heart Association treatment guidelines, the researchers found.
‘Although following treatment guidelines were found to be more important than patient volumes, lower-volume hospitals had worse adherence to important heart failure processes than higher-volume hospitals.’
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Interventional cardiologist Dharam Kumbhani, M.D. "There's a very small, incremental relationship between how many patients a hospital sees with heart failure and the actual patient outcome once you adjust for adherence to the guidelines," said lead author Dr. Dharam Kumbhani, an interventional cardiologist at UT Southwestern Medical Center. "But we found that lower-volume hospitals have worse adherence to important heart failure processes than higher-volume hospitals."
Heart failure, which the American Heart Association says affects 6.5 million Americans, results when damage to the heart leaves it unable to pump enough blood to support the body. Without a heart transplant, it can be fatal.
Medications such as beta-blockers, and medical devices such as defibrillators, are commonly used to help such patients. But researchers found that hospitals treating fewer patients were less likely to:
• prescribe beta-blockers or ACE inhibitors - medications commonly used for heart failure patients
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• install a defibrillator or cardiac resynchronization therapy (CRT) pacemaker.
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Rather than directing patients to larger institutions, which can involve travel barriers and added costs, a better solution would be to find ways to give more hospitals easy access to treatment guidelines, said Dr. Kumbhani, Assistant Professor of Internal Medicine, and an epidemiologist.
Source-Eurekalert