Impacto del seguimiento precoz desde atención primaria en el reingreso a 30días tras el alta hospitalaria por insuficiencia cardiaca / Impact of early follow-up from primary care on 30days readmission after heart failure hospitalization

Introducción Reducir ingresos por insuficiencia cardiaca (IC) es uno de los principales objetivos en el control de la enfermedad, por su impacto en el pronóstico y en el gasto sanitario. Los modelos transicionales al alta se imponen como una estrategia capaz de reducirlos, la mayoría basados en unidades hospitalarias específicas. Tratamos de valorar el impacto del seguimiento post-alta realizado desde atención primaria (AP). Material y métodos Estudio ecológico observacional retrospectivo en el área de referencia de un hospital terciario. Se efectúa un análisis de regresión lineal entre la tasa de seguimiento precoz desde el centro de salud tras un ingreso por IC y las tasas de reingreso a 30días por todas las causas a lo largo de 2021. Resultados El grado de seguimiento desde AP tras un alta hospitalaria por insuficiencia cardiaca se asocia con un menor reingreso a 30días por todas las causas (R de Pearson=0,53; p=0,02), con un descenso del 20%, similar al observado cuando se realiza desde otros dispositivos asistenciales y que se mantiene cuando se ajusta por complejidad de los pacientes. Conclusiones Tras un ingreso por IC, el seguimiento post-alta desde AP puede ser eficaz, reduciendo ingresos evitables y complementario al realizado por las unidades hospitalarias (AU)

Introduction Reducing heart failure (HF) admissions is one of the main objectives in disease control, due to its impact on prognosis and costs. The transitional models at discharge are imposed as a strategy capable of reducing hospitalizations, most of them based on specific hospital units. We analyzed the impact of the primary care (PC) post-discharge follow-up. Material and methods Retrospective observational study at the referral area of a tertiary hospital. Linear regression analysis was performed between early follow-up from the PC center after HF admission rate and the 30-day all-cause readmission rate throughout 2021. Results The degree of follow-up from PC after hospital discharge for heart failure is associated with fewer 30-day readmissions for all causes (Pearson's R=0.53, P=.02); with a decrease of 20%, similar to that observed when it is performed from other care facilities and which is maintained when adjusting for the complexity of the patients. Conclusions PC heart failure post-discharge follow-up could be effective in reducing hospitalizations, and is complementary to that carried out by hospital units (AU)

[Impact of early follow-up from primary care on 30days readmission after heart failure hospitalization]. / Impacto del seguimiento precoz desde atención primaria en el reingreso a 30días tras el alta hospitalaria por insuficiencia cardiaca.

INTRODUCTION: Reducing heart failure (HF) admissions is one of the main objectives in disease control, due to its impact on prognosis and costs. The transitional models at discharge are imposed as a strategy capable of reducing hospitalizations, most of them based on specific hospital units. We analyzed the impact of the primary care (PC) post-discharge follow-up. MATERIAL AND METHODS: Retrospective observational study at the referral area of a tertiary hospital. Linear regression analysis was performed between early follow-up from the PC center after HF admission rate and the 30-day all-cause readmission rate throughout 2021. RESULTS: The degree of follow-up from PC after hospital discharge for heart failure is associated with fewer 30-day readmissions for all causes (Pearson's R=0.53, P=.02); with a decrease of 20%, similar to that observed when it is performed from other care facilities and which is maintained when adjusting for the complexity of the patients. CONCLUSIONS: PC heart failure post-discharge follow-up could be effective in reducing hospitalizations, and is complementary to that carried out by hospital units.