Initiating a Congestive Heart Failure Clinic
Congestive Heart Failure (CHF) affects between 2 to 3 million people each year. Heart failure is directly responsible for the death of 39,000 Americans every year, and is a contributing factor in the death of an additional 225,000 Americans (National Institutes of Health, 2004). As more people continue to live longer, the incidence of heart failure will become more common. Caring healthcare facilities have the responsibility to assist these patients to improve their quality of life, and help them to help themselves.
In addition to the altruistic aspects of helping our clients, a fiscal feature comes into play. The majority of patients at the studied hospital have Medicare as their primary source of reimbursement. Medicare reimbursement is generally very low for the average admission, especially on subsequent admissions. The Department of Health and Human Services Centers for Medicare and Medicaid Services (2005) readily agrees that Medicare reimburses some cases less than the cost of treatment. Prevention of readmission for our clients with CHF, while initially appearing to be a capital expenditure, will ultimately result in a capital savings for the facility.
These writers propose the initiation of a clinic to advise congestive heart failure clients and assist them to improve their quality of life. The clinic will assist clients in managing their disease without the need for inpatient admissions. The writers will discuss justification of the project, demographics, estimated costs of equipment and staffing as well as methods of recouping costs and alternative funding. In addition, examination of the consequences of what not instituting the clinic will have on the outcome of clients.
Justification
Congestive Heart Failure and Shock or DRG 127 is our facility's second highest admitting DRG as well as our second highest readmission rate. In 2006, our facility had 148 readmissions for this
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