Reducción de ingresos y visitas a Urgencias en pacientes frágiles con insuficiencia cardíaca: resultados del programa asistencial UMIPIC / Reduction in hospitalisations and emergency department visits for frail patients with heart failure: results of the UMIPIC healthcare programme

Objetivos. La insuficiencia cardíaca (IC) es una enfermedad con una elevada morbimortalidad. Evaluamos la utilidad del programa de Unidades de Manejo Integral para Pacientes con IC (UMIPIC). Pacientes y método. Se analizaron los datos de los pacientes incluidos en el programa UMIPIC, recogidos en el registro de IC (RICA) de la Sociedad Española de Medicina Interna. Se compararon las visitas a Urgencias y las hospitalizaciones por cualquier causa y por IC durante el año anterior a la inclusión en el programa, con las que tuvieron durante el año de seguimiento posterior, usando el test de la chi-cuadrado. Resultados. Se incluyeron 258 pacientes (edad media 80 años, 51,9% mujeres). Durante el año previo hubo 693 hospitalizaciones por cualquier causa y 174 durante el seguimiento (reducción del 75%, p<0,001); 613 hospitalizaciones por IC el año antes y 92 durante el seguimiento (reducción del 85%, p<0,001); 655 vs 302 en cuanto a las visitas a Urgencias por cualquier causa (reducción del 53,9%, p<0,001); 440 vs 120 para las visitas a Urgencias por IC (reducción del 72%, p<0,001). No hubo diferencias significativas en el número de hospitalizaciones o visitas a Urgencias por otras causas diferentes a la IC. Conclusiones. El programa UMIPIC basado en la atención integral a pacientes ancianos con IC y comorbilidad reduce el porcentaje de reingresos hospitalarios y visitas a Urgencias durante el primer año de seguimiento (AU)

Objectives. Heart failure (HF) is a disease with high morbidity and mortality. We evaluated the usefulness of the Comprehensive Management Units for Patients with HF (Unidades de Manejo Integral para Pacientes con IC [UMIPIC]) programme. Patients and method. We analysed the patient data from the UMIPIC programme, which was recorded in the HF registry (RICA) of the Spanish Society of Internal Medicine. We compared emergency department visits and hospitalisations for any cause and for HF during the year prior to inclusion in the programme against those that occurred during the subsequent follow-up year, using the chi-squared test. Results. A total of 258 patients (mean age, 80years; 51.9% women) were included in the study. During the previous year, there were 693 hospitalisations for all causes and 174 hospitalisations during the follow-up (75% reduction, P<.001). There were 613 hospitalisations for HF during the previous year and 92 during the follow-up (85% reduction, P<.001); 655 vs. 302 in terms of emergency department visits for any cause (53.9% reduction, P<.001); and 440 vs. 120 for emergency department visits for HF (72% reduction, P<.001). There were no significant differences in the number of hospitalisations or emergency department visits for causes other than HF. Conclusions. The UMIPIC programme based on the comprehensive care of elderly patients with HF and comorbidity reduces the rate of hospital readmissions and emergency department visits during the first year of follow-up (AU)

Reduction in hospitalisations and emergency department visits for frail patients with heart failure: Results of the UMIPIC healthcare programme.

OBJECTIVES: Heart failure (HF) is a disease with high morbidity and mortality. We evaluated the usefulness of the Comprehensive Management Units for Patients with HF (Unidades de Manejo Integral para Pacientes con IC [UMIPIC]) programme. PATIENTS AND METHOD: We analysed the patient data from the UMIPIC programme, which was recorded in the HF registry (RICA) of the Spanish Society of Internal Medicine. We compared emergency department visits and hospitalisations for any cause and for HF during the year prior to inclusion in the programme against those that occurred during the subsequent follow-up year, using the chi-squared test. RESULTS: A total of 258 patients (mean age, 80years; 51.9% women) were included in the study. During the previous year, there were 693 hospitalisations for all causes and 174 hospitalisations during the follow-up (75% reduction, P<.001). There were 613 hospitalisations for HF during the previous year and 92 during the follow-up (85% reduction, P<.001); 655 vs. 302 in terms of emergency department visits for any cause (53.9% reduction, P<.001); and 440 vs. 120 for emergency department visits for HF (72% reduction, P<.001). There were no significant differences in the number of hospitalisations or emergency department visits for causes other than HF. CONCLUSIONS: The UMIPIC programme based on the comprehensive care of elderly patients with HF and comorbidity reduces the rate of hospital readmissions and emergency department visits during the first year of follow-up.