Khadijah Breathett1, Rachel D'Amico2, T M Ayodele Adesanya2, Stefanie Hatfield2, Shannon Willis2, Rodney X Sturdivant2, Randi E Foraker2, Sakima Smith2, Philip Binkley2, William T Abraham2, Pamela N Peterson2. 1. From the Division of Cardiology, University of Colorado, Anschutz Medical Campus, Aurora (K.B., P.N.P.); School of Medicine (R.D., T.M.A.A.), Division of Biostatistics (R.X.S.), and Division of Epidemiology (R.E.F.), Ohio State University, Columbus; Ohio State University Hospital East, Columbus (S.H.); Department of Medicine, Gwinnett Medical Center, Lawrenceville, GA (S.W.); Division of Biostatistics, Azusa Pacific University, CA (R.X.S.); Division of Cardiology, Ohio State University Wexner Medical Center, Columbus (S.S., P.B., W.T.A.); and Division of Cardiology, Denver Health Medical Center, CO (P.N.P.). khadijah.breathett@ucdenver.edu. 2. From the Division of Cardiology, University of Colorado, Anschutz Medical Campus, Aurora (K.B., P.N.P.); School of Medicine (R.D., T.M.A.A.), Division of Biostatistics (R.X.S.), and Division of Epidemiology (R.E.F.), Ohio State University, Columbus; Ohio State University Hospital East, Columbus (S.H.); Department of Medicine, Gwinnett Medical Center, Lawrenceville, GA (S.W.); Division of Biostatistics, Azusa Pacific University, CA (R.X.S.); Division of Cardiology, Ohio State University Wexner Medical Center, Columbus (S.S., P.B., W.T.A.); and Division of Cardiology, Denver Health Medical Center, CO (P.N.P.).
Abstract
BACKGROUND: Timely follow-up after hospitalization for heart failure (HF) is recommended. However, follow-up is suboptimal, especially in lower socioeconomic groups. Patient-centered solutions for facilitating follow-up post-HF hospitalization have not been extensively evaluated. METHODS AND RESULTS: Face-to-face surveys were conducted between 2015 and 2016 among 83 racially diverse adult patients (61% African American, 34% Caucasian, and 5% Other) hospitalized for HF at a university hospital centered in a low-income area of Columbus, Ohio. Patient perceptions of methods to facilitate follow-up post-HF hospitalization and likelihood of using interventions were investigated using a Likert scale: 1=very much to 5=not at all. Results were analyzed by Wilcoxon signed-rank test with Bonferroni correction. The response rate was 82%. The annual household income was <$35 000 for 49% of patients. An appointment near the patient's home was the most desired intervention (77%), followed by reminder message (73%), transportation to appointment (63%), and elimination of copayment (59%). Interventions most likely to be used if provided were similarly ranked: reminder message (48%), appointment near home (46%), elimination of copay (46%), and transportation to appointment (39%). There were significant differences (P=0.001) in high-ranking interventions related to location (appointment near home, transportation, home appointment) and reminder for visit compared with low-ranking interventions related to time (weekend appointment, appointment after 5 pm) and telemedicine. CONCLUSIONS: Among this cohort of racially diverse low-income patients hospitalized with HF, an appointment near the patient's home and a reminder message were the most desired interventions to facilitate follow-up. Further study of similar populations nationwide is warranted.
BACKGROUND: Timely follow-up after hospitalization for heart failure (HF) is recommended. However, follow-up is suboptimal, especially in lower socioeconomic groups. Patient-centered solutions for facilitating follow-up post-HF hospitalization have not been extensively evaluated. METHODS AND RESULTS: Face-to-face surveys were conducted between 2015 and 2016 among 83 racially diverse adult patients (61% African American, 34% Caucasian, and 5% Other) hospitalized for HF at a university hospital centered in a low-income area of Columbus, Ohio. Patient perceptions of methods to facilitate follow-up post-HF hospitalization and likelihood of using interventions were investigated using a Likert scale: 1=very much to 5=not at all. Results were analyzed by Wilcoxon signed-rank test with Bonferroni correction. The response rate was 82%. The annual household income was <$35 000 for 49% of patients. An appointment near the patient's home was the most desired intervention (77%), followed by reminder message (73%), transportation to appointment (63%), and elimination of copayment (59%). Interventions most likely to be used if provided were similarly ranked: reminder message (48%), appointment near home (46%), elimination of copay (46%), and transportation to appointment (39%). There were significant differences (P=0.001) in high-ranking interventions related to location (appointment near home, transportation, home appointment) and reminder for visit compared with low-ranking interventions related to time (weekend appointment, appointment after 5 pm) and telemedicine. CONCLUSIONS: Among this cohort of racially diverse low-income patients hospitalized with HF, an appointment near the patient's home and a reminder message were the most desired interventions to facilitate follow-up. Further study of similar populations nationwide is warranted.
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