Effect of Home Care Program on Re-hospitalization in Advanced Heart Failure

Abstract

Background: Heart failure is the leading cause of readmission in all medical and surgical patients. Home care studies have reduced hospitalization in heart failure. This study aimed to investigate the effect of home care program on readmission in advanced heart failure. Materials and Methods: The study was a randomized clinical trial conducted at the Rajaie Cardiovascular, Medical and Research Center from September 2017 to March 2018. Ninety-eight patients with advanced heart failure were selected using census method and were randomly divided into experimental and control groups. For the experimental group, the home care program was implemented for 6 months. The date and frequency of hospitalization were recorded during 30, 90, and 180 days before and after the home care program. The quantitative data analysis was performed using Mann–Whitney and Wilcoxon's signed-rank tests and qualitative data analysis was performed using the Chi-square test. Results: The number of hospitalization and length of hospital stay 30, 90, and 180 days after implementation of the home care program in the experimental group was significantly less than the control group (p < 0.001). The number of hospitalizations and length of stay in the experimental group decreased significantly after the program (p < 0.001). In the control group, 90 days after the intervention, the number of hospitalizations (p = 0.013) and length of stay increased significantly (p < 0.001), and 180 days after the intervention, increased significantly (p < 0.001). Conclusions: The implementation of a designed home care program reduces readmission and the length of hospital stay in advanced heart failure.