“Although current guidelines recommend early follow-up after hospital discharge, it is unclear if it is beneficial in patients sent home from the ED and whether this follow-up should be with a familiar [clinician],” Robinder S. Sidhu, MD, of the University of Alberta in Edmonton, Canada, and colleagues reported in the Journal of the American College of Cardiology: Heart Failure.
To assess the effect of provider continuity on clinical outcomes, researchers analyzed data from 12,285 patients (mean age, 74.9 years) who were treated and released from the ED with a first-time diagnosis of heart failure.
Patients with heart failure who received follow-up care from a familiar provider versus an unfamiliar provider after ED discharge were less likely to experience hospitalization or death at three months (adjusted hazard ratio, 0.79; 95% CI: 0.71-0.89), at six months (aHR, 0.86; 95% CI: 0.77-0.95), and at 12 months (aHR, 0.87; 95% CI: 0.80-0.96).
Follow-up care with any provider within 30 days of discharge from the ED was associated with reduced risk of repeat ED visit, or death at six months.
“Early follow-up after an ED visit is associated with better outcomes, particularly if conducted with a familiar [provider],” wrote the researchers.