Highlights and Brief Lay Summary
- •An interprofessional collaborative practice can be a successful model in caring for underserved patients with heart failure.
- •Addressing social determinants of health can lead to improved heart failure outcomes.
- •Decreasing hospital readmissions among underserved patients with heart failure can significantly decrease costs for hospitals.
Abstract
Background
Heart failure is a leading cause of hospitalization among adults in the United States.
Nurse-led interprofessional clinics have been shown to improve heart failure outcomes
in patients with heart failure, specifically decreasing readmission rates. Yet, there
is little information on the impact of nurse-led interprofessional collaborative practice
within an underserved population with heart failure. Thus, the purpose of this study
was to compare the differences in readmission days and cost in patients followed by
an interprofessional collaborative practice clinic (both engaged and not engaged)
and those who did not establish care with the clinic.
Methods and Results
Demographic, clinical, and readmission data were compared among patients with heart
failure (59% African American; 72% male; mean age, 49 years) stratified into 3 groups:
engaged patients (n = 170), not-engaged patients (n = 103), and not-established patients (n = 111) who had an initial appointment to clinic but did not establish care. Patients
with 6 months of data before and after the scheduled clinic visit were included in
the study. Differences in baseline characteristics, frequency and length of hospital
admissions, and costs were analyzed using analysis of variance, Wilcoxon matched-pairs
testing, multivariate analysis of variance, logistic regression, and financial analytics.
Overall, the number of inpatient hospital days decreased in the engaged group compared
with those in the not-engaged and not-established groups (P < .001). The total cost savings were significantly greater in the engaged group ($1,987,379)
(P < .001).
Conclusions
The findings of this study may steer health care providers to incorporate interprofessional
collaborative practice into heart failure management with a particular focus on underserved
populations.
Key Words
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Article info
Publication history
Published online: May 12, 2021
Accepted:
April 26,
2021
Received in revised form:
April 1,
2021
Received:
January 25,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
