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

被引:8
|
作者
Razavi, Alexander C. [1 ,2 ]
Monlezun, Dominique J. [1 ,2 ,3 ]
Sapin, Alexander [1 ,2 ]
Sarris, Leah [1 ]
Schlag, Emily [1 ,2 ]
Dyer, Amber [1 ]
Harlan, Timothy [1 ]
机构
[1] Tulane Univ, Sch Med, Goldring Ctr Culinary Med, 1430 Tulane Ave, New Orleans, LA 70112 USA
[2] Tulane Univ, Sch Publ Hlth & Trop Med, New Orleans, LA 70112 USA
[3] Univ Texas MD Anderson Canc Ctr, Houston, TX 77030 USA
关键词
heart failure; cooking; nutrition therapy; patient readmission; lifestyle; ACUTE MYOCARDIAL-INFARCTION; CARDIOVASCULAR-DISEASE; MEDITERRANEAN DIET; DASH DIET; HOSPITALIZATION; INTERVENTION; PREVENT; RISK; METAANALYSIS; MORTALITY;
D O I
10.1177/1559827619861933
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
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.
引用
收藏
页码:351 / 360
页数:10
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