cheap youth mlb baseball jerseys A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failure
This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. The approach consisted of: intensive education about congestive heart failure and its treatment by an experienced cardiovascular research nurse; individualised dietary assessment and instruction given by a registered dietician; consultation with social service personnel to facilitate discharge planning and care; an analysis of medications by a geriatric cardiologist who made specific recomm endations to eliminate unnecessary medications and simplify the overall regimen; and intensive follow up after discharge through the hospital’s home care services,
supplemented by individualised home visits and telephone contact with the members of the study team. The economic study was carried out in the USA.Dates to which data relateEffectiveness and resource usage data related to the period July 1990 to June 1994. Costs were presented in 1994 prices, and collected in the last year of the study.Source of effectiveness dataThe effectiveness data was derived from a single study.Link between effectiveness and cost dataThe costing was undertaken prospectively on a sample of patients during the final year of the study.Study sampleAll patients 70 years of age or older admitted to medical wards were screened for congestive heart failure. Patients with confirmed heart failure were eligible to participate if they had at least one of the following risk factors for early readmission: prior history of heart failure, 4 or more hospitalisations for any reason in the preceding 5 years, or congestive heart failure precipitated by either an acute myocardial infarction or uncontrolled hypertension. they lived outside the catchment area). There were 140 patients in the control group and 142 patients in the treatment group.Study designThe study was a single centre prospective randomised trial. The patients underwent blinded randomisation with the use of a computer generated list of random numbers immediately after consenting to participate. The primary health outcome was survival for 90 days without readmission. The treatment and control groups were well balanced with regard to most baseline characteristics. However, the pa tients in the treatment group were somewhat older and better educated,
had higher heart rates on baseline electrocardiogram and were more likely to have undergone previous coronary artery revascularization.