Non-Attendance to Heart Failure Outpatient Appointments: Trends and Challenges.

Abstract

Background: Population growth and macroeconomic factors have strained the capacity of hospitals to meet ambulatory care needs. Non-attendance to outpatient appointments is associated with higher readmissions and poorer outcomes. We assessed the trends in admission and non-attendance to outpatient heart failure clinics (OPHC). Method(s): In patients admitted with decompensated heart failure to cardiology and non-cardiology units at Northern Health, Victoria, we assessed time to first outpatient appointment and percentage of appointments non-attended across two time periods (TP) (TP1: 6/2019-6/2020 and. TP2: 1/2022-1/2023). We assessed predictors for multiple admissions with HF within each time point. Result(s): A total of 2,079 (1,088 in TP1 and 991 in TP2) patients were admitted with heart failure and 1,243 patients received an OPHC appointment within 12 months. Percentage admitted under cardiology increased from 33% to 40% (p<0.01). Patients admitted under non-cardiology units were less likely to receive an OPHC appointment and the percentage decreased between time periods (58% vs. 42%, p<0.01). Overall attendance to the first OPHC was 78% with no significant difference between time periods or admitting units. Risk for multiple admissions was higher in TP2 compared to TP1 (Table 1). Attendance to OPHC and a cardiology unit admission was associated with lower risk of multiple HF admissions. Time to first OPHC post-discharge increased by on average 29 days between time periods (p<0.01). Conclusion(s): Improving attendance and capacity of OPHC can help reduce readmissions and improve clinical outcomes. [Formula presented]Copyright � 2024