Etiological Role of Diet in 30-Day Readmissions for Heart Failure: Implications for Reducing Heart Failure–Associated Costs via Culinary Medicine

Author:

Razavi Alexander C.123ORCID,Monlezun Dominique J.123,Sapin Alexander123,Sarris Leah123,Schlag Emily123,Dyer Amber123,Harlan Timothy123

Affiliation:

1. Goldring Center for Culinary Medicine, Tulane University School of Medicine, New Orleans, Louisiana (ACR, DJM, AS, LS, ES, AD, TH)

2. Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana (ACR, DJM, AS, ES)

3. University of Texas M.D. Anderson Cancer Center, Houston, Texas (DJM)

Abstract

Background. Reducing the under-30-day readmission for heart failure (HF) patients is a modifiable quality-of-care measure, yet the role of diet in HF readmissions and cost-effective HF care remain ill-defined. Methods. Medical chart review was conducted to determine cause(s) for HF treatment failure. Randomized controlled trial–backed machine learning models were employed to assess the relationship of culinary medicine education with HF 30-day readmission rate and cost. Results. Of 1031 HF admissions, 130 occurred within 30 days of discharge (12.61%.) Nearly two-thirds of individuals were male (64.02%), while the mean age and median length of stay were 64.33 ± 14.02 and 2, respectively. Medication noncompliance (34.62%) was the most common etiology for 30-day readmissions, followed by dietary noncompliance (16.92%), comorbidity (16.92%), a combination of dietary and medication noncompliance (10%), HF exacerbation (10%), iatrogenic (10%), and drug abuse (1.54%). Medication noncompliance contributed to the highest gross charge by readmission, costing a total of $1 802 096. Compared with traditional care, culinary medicine education for HF patients would prevent 93 HF readmissions and save $3.9 million in an estimated 4-year period. Conclusion. Though pharmacological treatment remains a focal point of HF management, diet-based approaches may improve tertiary HF prevention and reduce HF-associated health care expenditures.

Funder

National Institutes of Health

Goldring Family Foundation

Robert Wood Johnson Foundation

Woldenburg Family Foundation

Humana Foundation

Publisher

SAGE Publications

Subject

Public Health, Environmental and Occupational Health,Health Policy,Medicine (miscellaneous)

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