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Associations of patient demographic characteristics and regional physician density with early physician follow-up among medicare beneficiaries hospitalized with heart failure.

Publication ,  Journal Article
Kociol, RD; Greiner, MA; Fonarow, GC; Hammill, BG; Heidenreich, PA; Yancy, CW; Peterson, ED; Curtis, LH; Hernandez, AF
Published in: Am J Cardiol
October 1, 2011

Early physician follow-up after a heart failure (HF) hospitalization is associated with lower risk of readmission. However, factors associated with early physician follow-up are not well understood. We identified 30,136 patients with HF ≥65 years at 225 hospitals participating in the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE) registry or the Get With The Guidelines-Heart Failure (GWTG-HF) registry from January 1, 2003 through December 31, 2006. We linked these clinical data to Medicare claims data for longitudinal follow-up. Using logistic regression models with site-level random effects, we identified predictors of physician follow-up within 7 days of hospital discharge. Overall 11,420 patients (37.9%) had early physician follow-up. Patients residing in hospital referral regions with higher physician concentration were significantly more likely to have early follow-up (odds ratio 1.29, 95% confidence interval 1.12 to 1.48, for highest vs lowest quartile). Patients in rural areas (0.84, 0.78 to 0.91) and patients with lower socioeconomic status (0.79, 0.74 to 0.85) were less likely to have early follow-up. Women (0.87, 0.83 to 0.91) and black patients (0.84, 0.77 to 0.92) were less likely to receive early follow-up. Patients with greater co-morbidity were less likely to receive early follow-up. In conclusion, physician follow-up within 7 days after discharge from a HF hospitalization varied according to regional physician density, rural location, socioeconomic status, gender, race, and co-morbid conditions. Strategies are needed to ensure access among vulnerable populations to this supply-sensitive resource.

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Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

October 1, 2011

Volume

108

Issue

7

Start / End Page

985 / 991

Location

United States

Related Subject Headings

  • United States
  • Time Factors
  • Retrospective Studies
  • Registries
  • Quality of Health Care
  • Physicians
  • Patient Readmission
  • Patient Discharge
  • Medicare
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
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Kociol, R. D., Greiner, M. A., Fonarow, G. C., Hammill, B. G., Heidenreich, P. A., Yancy, C. W., … Hernandez, A. F. (2011). Associations of patient demographic characteristics and regional physician density with early physician follow-up among medicare beneficiaries hospitalized with heart failure. Am J Cardiol, 108(7), 985–991. https://doi.org/10.1016/j.amjcard.2011.05.032
Kociol, Robb D., Melissa A. Greiner, Gregg C. Fonarow, Bradley G. Hammill, Paul A. Heidenreich, Clyde W. Yancy, Eric D. Peterson, Lesley H. Curtis, and Adrian F. Hernandez. “Associations of patient demographic characteristics and regional physician density with early physician follow-up among medicare beneficiaries hospitalized with heart failure.Am J Cardiol 108, no. 7 (October 1, 2011): 985–91. https://doi.org/10.1016/j.amjcard.2011.05.032.
Kociol RD, Greiner MA, Fonarow GC, Hammill BG, Heidenreich PA, Yancy CW, et al. Associations of patient demographic characteristics and regional physician density with early physician follow-up among medicare beneficiaries hospitalized with heart failure. Am J Cardiol. 2011 Oct 1;108(7):985–91.
Kociol, Robb D., et al. “Associations of patient demographic characteristics and regional physician density with early physician follow-up among medicare beneficiaries hospitalized with heart failure.Am J Cardiol, vol. 108, no. 7, Oct. 2011, pp. 985–91. Pubmed, doi:10.1016/j.amjcard.2011.05.032.
Kociol RD, Greiner MA, Fonarow GC, Hammill BG, Heidenreich PA, Yancy CW, Peterson ED, Curtis LH, Hernandez AF. Associations of patient demographic characteristics and regional physician density with early physician follow-up among medicare beneficiaries hospitalized with heart failure. Am J Cardiol. 2011 Oct 1;108(7):985–991.
Journal cover image

Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

October 1, 2011

Volume

108

Issue

7

Start / End Page

985 / 991

Location

United States

Related Subject Headings

  • United States
  • Time Factors
  • Retrospective Studies
  • Registries
  • Quality of Health Care
  • Physicians
  • Patient Readmission
  • Patient Discharge
  • Medicare
  • Male