December 4, 2017 – Avoiding the Hospital

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Anchor lead: Keeping people with heart failure out of the hospital may not be a good choice, Elizabeth Tracey reports

People with heart failure whose hospitals took measures to keep them from being readmitted died at higher rates than those who came back to the hospital, a recent study in the Journal of the American Medical Association found. Alicia Arbaje, a geriatrics expert at Johns Hopkins, says her own research points to a likely reason.

Arbaje: When we try to keep people at home we may not be as effective. In our own work studying home health care services after hospital discharge what we found it that one of the top three challenges that nurses face when they see a patient at home is that the patient is actually not appropriate for home-based level of care. That really they should have gone to a higher level of care like a skilled nursing facility or what they really needed was hospice care, and so nurses are finding that it’s not within their score of work as currently organized to care for these people with really complex issues. :30

Arbaje notes that heart failure is increasingly common among older people so coming to terms with this issue of home care is important. At Johns Hopkins, I’m Elizabeth Tracey.