Impact on Accessibility to Care and Outcomes of a Clinician-to-Clinician Electronic Consultation Program in Heart Failure Patients with Previous Hospital Admissions: Implications for Heart Failure Care

Autor: David García-Vega, Pilar Mazon-Ramos, Manuel Portela-Romero, Moisés Rodríguez-Mañero, Daniel Rey-Aldana, Manuela Sestayo-Fernandez, Sergio Cinza-Sanjurjo, Jose Ramon González-Juanatey
Rok vydání: 2023
DOI: 10.20944/preprints202305.1056.v1
Popis: (1) Objectives. Patients with heart failure (HF) who experience hospitalizations for worsening HF (HFH) are at high risk of subsequent events. We aimed to evaluate the impact of an outpatient care management program that includes a clinician-to-clinician e-consultation using an integrated electronic medical record in a healthcare area with a widely dispersed population on delay time in care, hospital admissions, and mortality in a high-risk group of patients with HF and previous episodes of HFH. (2) Methods. We selected 6,444 HF patients who visited the cardiology service at least once between 2010 and 2021. Of these, 4,851 were attended in e-consult, and 2,008 in one-time in-person consultations. In 2,230 HF patients, there was documentation of a previous episode of HFH. Using an interrupted time series regression model, we analysed the impact of incorporating e-consult into the health care model in the group of patients with HFH and evaluated the elapsed time to cardiology care, heart failure (HF), cardiovascular (CV), and all-cause hospital admissions and mortality, calculating the incidence relative risk (iRR). (3) Results. In the group of patients with previous HF hospitalizations, the introduction of e-consult substantially decreased waiting times to cardiology care. The time elapsed to care after e-consult implementation was significantly reduced compared with the previous in-person period (8.6 [8.7] vs 55.4 [79.9] days, p
Databáze: OpenAIRE