Heart failure accounts for 6.5 million hospital days a year, and a new study reported in the Journal for Healthcare Quality showed that Medicaid patients and those with comorbid illnesses have longer lengths of stay for treatment of heart failure. The Journal of Healthcare Quality is the peer-reviewed publication of the National Association for Healthcare Quality (NAHQ, www.nahq.org).
Medicare and Medicaid reimbursements will be reduced under provisions of the Affordable Care Act for hospitalized conditions such as heart failure, so it is imperative for hospitals to consider how cost reductions may influence the quality of care for vulnerable populations. Researchers at Ohio State University and the University of North Carolina analyzed heart failure length of stay data from the Atherosclerosis Risk in Communities cohort from 1987 to 2005. They evaluated 1,300 patients with incident hospitalized heart failure and investigated the association of socioeconomic status with length of stay.
Results showed that patients living in lower socioeconomic areas did not have longer lengths of stay than patients with higher socioeconomic status. Instead, the study showed that Medicaid patients and individuals with comorbid illnesses had longer stays than other heart-failure patients. The authors concluded that receipt of Medicaid and presence of comorbid illnesses are associated with a greater burden of illness, which usually dictates longer hospital stays to assure patients are well enough for discharge.
National Association for Healthcare Quality