Hospital-community-based collaborative management in health care of elderly out-patients with chronic heart failure

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Author:
ZHANG Ling-ling(Department of Cadre Health Care, Binzhou People's Hospital, Binzhou 256610, China)
DONG Xing-ping(Department of Cadre Health Care, Binzhou People's Hospital, Binzhou 256610, China)
WU Su-hua(Department of Cadre Health Care, Binzhou People's Hospital, Binzhou 256610, China)
HE Shu-feng(Department of Cadre Health Care, Binzhou People's Hospital, Binzhou 256610, China)
Journal Title:
Chinese Journal of Health Management
Issue:
Volume 06, Issue 05, 2012
DOI:
10.3760/cma.j.issn.1674-0815.2012.05.003
Key Word:
Elderly;Hospital;Community;Chronic heart failure;Health management

Abstract: Objective To explore the effect of hospital-community-based collaborative management on elderly out-patients with chronic heart failure (CHF).Methods A total of 228 out-patients with CHF were randomly assigned to the community-based health management group (n =106 ) and the hospitalcommunity-based collaborative health management group (n =122).In community-based health management group,the patients only received community-based health management,while in hospital-community-based collaborative health management group the patients accepted comprehensive health management.One year later,medication compliance,readmission rate,mortality,average length of hospitalization,medical costs and Minnesota living with heart failure questionnaire (LiHFe) were compared between the two groups.Results No statistically significant differences in clinical data were found between the two groups at baseline.After one year,medication compliance was significantly improved in hospital-community-based collaborative health management group when compared to community-based health management group ( x2 =8.97,P < 0.05 ).Readmission rate,average length of hospitalization and medical costs of hospital-community-based collaborative health management group were lower than community-based health management group (x2 =9.91 ; t =3.78,3.61 ; all P < 0.05 ).One year ago,the items of LiHFe including physical dimension,emotion,symptom and social dimension and total score showed no significant between the two group (t =0.42,0.81,0.66,0.44,0.41 ; all P > 0.05 ).While one year later,all the scores of hospital-communitybased collaborative health management group were significantly declined( t =6.37,11.81,6.16,9.64,9.13;P < 0.05 ).Mortality showed no significant difference between the two groups ( x2 =0.247,P > 0.05 ).Conclusion Hospital-community-based collaborative management for health care may be a practical and valuable strategy for decreasing readmission rate and medical burden and improving quality of life of elderly patients with CHF.

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