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Fergenbaum J, Bermingham S, Krahn M, et al. Care in the home for the management of chronic heart failure: Systematic review and cost-effectiveness analysis Journal of Cardiovascular Nursing. 2015 February.
Do homecare services delivered to patients with chronic heart failure (CHF) lead to improved clinical outcomes and health system cost savings?
A growing number of patients are being diagnosed with CHF, leading to functional limitations, fatigue and shortness of breath. Patients with CHF are at high risk of heart complications and may frequently visit hospitals and emergency rooms.
Services delivered in patients’ homes can include nurse-led education to support self-care and rehabilitation, and support for informal caregivers.
Homecare services for patients with CHF are a promising means of reducing hospital and emergency room visits, and improving patient health outcomes and quality of life, while also leading to health system cost savings.
A number of electronic databases were searched for studies published between January 2006 and January 2012, and those that focused on evaluating the effectiveness of homecare services delivered to patients with CHF were included in the review.
A total of 1,277 studies were identified in searches, and six were included in the review after assessments for eligibility.
This review was funded by Health Quality Ontario.
CHF patients receiving homecare services experienced fewer hospitalizations, fewer emergency department visits, and higher quality of life compared with patients receiving usual care.
In total, this review estimates that homecare services resulted in a net health system savings of $10,665 per patient. Most of the cost savings came as a result of having fewer hospitalizations.
CHF patients experienced larger than average improvements in quality of life after receiving homecare services, compared with usual care.
This review found that homecare services delivered to patients with CHF reduced patient hospitalizations and emergency room visits, and improved patient quality of life. Home-care services were also found to save the health system money, and improve patient quality of life, suggesting that implementing homecare services for patients with CHF could be more effective and less costly than usual care.
This summary is based on a review that was determined to be of medium methodological quality based on an assessment using the AMSTAR tool.