A recent study from the Yale School of Medicine suggests that acute heart failure patients may benefit from palliative care after being released from the hospital. Patients responded to a questionnaire after about two days after hospital admission and ten days after discharge. About half of acute heart failure patients see no improvement in fatigue (58%), dyspnea (42%), anxiety (41%), or pain (41%) within the first few days of discharge.
“Our findings suggest that patients who are hospitalized for HF often present with symptoms that are not traditionally associated with HF and that current management approaches may fail to adequately address symptoms,” wrote Dr. Rabeca F. Khan and colleagues, in a research letter published in JAMA Internal Medicine.
While Khan recognizes that further studies are necessary to determine the impact of palliative care on readmission rates and symptoms, Yale has already decided to involve their palliative team in the care given to heart failure patients.
Our Take: Palliative care is one of the least understood forms of health care. In this study, fewer than one in four patients said they were familiar with palliative care, and many of those patients had misconceptions about its use. Most people associate palliative care with end-of-life care, but as this research suggests, there are other times along the care continuum where it may be indicated.
After understanding how it works, 68% of patients in the study stated an interest in receiving palliative care after heart surgery.
Hospitals and ACOs are rightly concerned with readmission rates because of the financial incentive to keep rates low. Despite heart failure being a leading cause of 30-day readmission rates, less than 10% of heart failure patients receive palliative care. While this is a small study (91 patients), the results should alert administrators that care managers may be insufficient for patients with heart failure.
And it presents itself as another opportunity for post-acute care providers to be a meaningful partner in the world of value-based care.