Impact of Outpatient Diuretic Infusion Therapy on Healthcare Cost and Readmissions.

Background and objectives: Heart failure (HF) is a complex syndrome with multiple etiologies resulting in impaired ventricular filling or pumping of blood. HF is as a major public health concern that leads to significant morbidity and mortality resulting in an enormous financial burden on the healthcare system. The study objectives were to assess the 30-day hospital readmission rates and its financial impact on the hospital.

Methods: The study was a retrospective single-center analysis of decoded data of all HF patients admitted to an outpatient diuretic infusion program. Adult patients who were readmitted to the hospital within 30 days despite guideline derive medical therapy were included if they were enrolled in the outpatient diuretic infusion clinic. Adult patients who were included in this study received a furosemide dose of 40 mg intravenously (infusion over 3 hours) at the clinic visit. Patients whose clinical signs/symptoms improved and remained stable in consequent visits were eventually discharged from the clinic. Financial impact was assessed using data obtained from the hospital administration on cost of HF readmissions.

Results: The results show a 30-day hospital readmission rate at 6-9% in the years analyzed (n=56) with a net savings of $562,815 to $736,560 per year.

Conclusions: This treatment strategy has no detrimental effects in addition to generating substantial financial savings. It appears to be a useful addition to the existing medical treatment regimens chronic HF patients.