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  • Bhatia, V. (author)

Beta-blocker Use and 30-day All-cause Readmission in Medicare Beneficiaries with Systolic Heart Failure

  • Article/chapterEnglish2015

Publisher, publication year, extent ...

  • Elsevier BV,2015

Numbers

  • LIBRIS-ID:oai:gup.ub.gu.se/219674
  • https://gup.ub.gu.se/publication/219674URI
  • https://doi.org/10.1016/j.amjmed.2014.11.036DOI

Supplementary language notes

  • Language:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • BACKGROUND: Beta-blockers improve outcomes in patients with systolic heart failure. However, it is unknown whether their initial negative inotropic effect may increase 30-day all-cause readmission, a target outcome for Medicare cost reduction and financial penalty for hospitals under the Affordable Care Act. METHODS: Of the 3067 Medicare beneficiaries discharged alive from 106 Alabama hospitals (1998-2001) with a primary discharge diagnosis of heart failure and ejection fraction <45%, 2202 were not previously on beta-blocker therapy, of which 383 received new discharge prescriptions for beta-blockers. Propensity scores for beta-blocker use, estimated for each of the 2202 patients, were used to assemble a matched cohort of 380 pairs of patients receiving and not receiving beta-blockers who were balanced on 36 baseline characteristics (mean age 73 years, mean ejection fraction 27%, 45% women, 33% African American). RESULTS: Beta-blocker use was not associated with 30-day all-cause readmission (hazard ratio [HR] 0.87; 95% confidence interval [CI], 0.64-1.18) or heart failure readmission (HR 0.95; 95% CI, 0.57-1.58), but was significantly associated with lower 30-day all-cause mortality (HR 0.29; 95% CI, 0.12-0.73). During 4-year postdischarge, those in the beta-blocker group had lower mortality (HR 0.81; 95% CI, 0.67-0.98) and combined outcome of all-cause mortality or all-cause readmission (HR 0.87; 95% CI, 0.74-0.97), but not with all-cause readmission (HR 0.89; 95% CI, 0.76-1.04). CONCLUSIONS: Among hospitalized older patients with systolic heart failure, discharge prescription of beta-blockers was associated with lower 30-day all-cause mortality and 4-year combined death or readmission outcomes without higher 30-day readmission. Published by Elsevier Inc.

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Bajaj, N. S. (author)
  • Sanam, K. (author)
  • Hashim, T. (author)
  • Morgan, C. J. (author)
  • Prabhu, S. D. (author)
  • Fonarow, G. C. (author)
  • Deedwania, P. (author)
  • Butler, J. (author)
  • Carson, P. (author)
  • Love, T. E. (author)
  • Kheirbek, R. (author)
  • Aronow, W. S. (author)
  • Anker, S. D. (author)
  • Waagstein, Finn,1938Gothenburg University,Göteborgs universitet,Institutionen för medicin,Institute of Medicine(Swepub:gu)xwaafi (author)
  • Fletcher, R. (author)
  • Allman, R. M. (author)
  • Ahmed, A. (author)
  • Göteborgs universitetInstitutionen för medicin (creator_code:org_t)

Related titles

  • In:American Journal of Medicine: Elsevier BV128:7, s. 715-7210002-9343

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