Essay On Congestive Heart Failure
My current practice setting is primarily based out of the hospital and quality care measures as well as cost analyses are certainly of big concern this day and time. Providers are constantly making sure that all "quality indicators" are present on each and every cardiac consult that is encountered and making sure that the documentation supports the reason why a certain "quality indicator" is not indicated on the individual patient. What I find thought provoking is that although I may discharge a chronic systolic heart failure patient on all the core measure medications and they demonstrated improvement while in the hospital for the 3 to 4 days that they are allowed for that admission, they still bounce right back into the hospital for "congestive …show more content…
One week later(or sooner), the patient comes back to the emergency room for dyspnea. The emergency room admits them to the primary care and then primary care consults cardiology for congestive heart failure. Cardiology reviews chest x ray which reveals "no acute cardiopulmonary process". So, I wonder why did the patient get readmitted for "congestive heart failure"? A BNP level is checked and it is elevated, but less than it was when they were discharged from the hospital? The patient has multiple other possibly differential diagnoses for dyspnea, so why is the patient readmitted for heart failure? The patient also has COPD, tobacco abuse, and weighs over 300 pounds. Is it perhaps patient's cannot be admitted for the diagnosis of tobacco abuse and morbid obesity? Despite extensive counseling, that the patient is not going to stop smoking so therefore, they are not going to be able to afford their medications. This scenario is never ending unfortunately, and although all efforts are being made to ensure quality care measures are in place, it does not really seem to matter. Risk adjustment methods are certainly another ball of wax and ideally those patients that I mentioned above should be penalized for their risk behaviors and not the providers that are trying their hardest not to be "dinged" for a readmission of "congestive
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