In this large retrospective observational cohort of CHF medicare patients, from 1993 to 2006, there were substantial decreases in mean LOS (from 8.8 to 6.3 day) and in-hospital mortality (9% to 4%). However, there were substantial increases in the percentage of patients discharged to skilled nursing facilities (13% to 20%) and the percentage of patients readmitted within 30 days (17% to 20%). These increases are likely reflecting CHF patients living longer and living sicker. However, new Medicare incentives to reduce readmission rates may push the pendulum back to longer LOS (abstract).
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.