CHF Patients May Fare Better, Pay More at High-Volume Hospitals

It's well-established that the more surgical and cardiovascular procedures performed at a given hospital, the better the chances for improved outcomes. That's also true for hospitals that treat congestive heart failure, a new study concludes.

Hospitals with greater experience treating CHF patients demonstrate lower patient mortality, fewer readmissions, and higher quality scores than hospitals with fewer such patients.

"Patients discharged from hospitals with 200 CHF discharges had, on average, 18% lower odds of death than those discharged from hospitals with 20 CHF discharges," says the study published this week in the Annals of Internal Medicine.

"However, the typical stay at a hospital with 200 CHF discharges would cost approximately $400 more per hospitalization," wrote the authors, Karen E. Joynt, MD, John Orav and Ashish K. Jha, MD, of the Harvard School of Public Health. 

With an estimated 1.4 million hospitalizations for patients with CHF in 2007 alone, and because one in 10 CHF patients die within 30 days of hospitalization and one in four survivors is readmitted, their finding has important implications for public health, they wrote.

They added that benefits of volume apparently reach a threshold "beyond which additional volume was associated with little additional benefit," decreasing "once volume reached approximately 200 Medicare CHF discharges," over the study period of 23 months.