vasodilators (especially ACE inhibitors), and spironolactone—have shown improved survival in patients with heart failure caused by reduced LVEF. Treatment for patients with heart failure and preversed systolic function is empirical but ultimately includes many of the same medications used to treat systolic heart failure. For all patients with heart failure, education on prognosis and self-care is essential (Steimle, 2007). A3. Managed Disease Process We are making great progress in controlling the epidemic of coronary artery disease that plagued much of the last century. Incidence has declined, and treatment of acute coronary artery disease has resulted in a greatly increased life expectancy. However, improved treatment may have reduced immediate mortality, but it often leaves patients with chronic myocardial dysfunction. This is an important factor contributing to the increased incidence of congestive heart failure (CHF), the cardiovascular condition most rapidly on the rise (Giannetti, 2001).
ADVANCED INFORMATION MANAGEMENT AND THE APPLICATIO 11 Guidelines have been established for the evaluation and treatment of CHF. 4 These recommendations include assessment for the underlying cause, determination of left ventricular function to distinguish between diastolic and systolic dysfunction, and recommendations for the use of medications. For patients with CHF, particularly those with left ventricular dysfunction, there is overwhelming evidence that appropriate management can alleviate symptoms and enhance survival (Giannetti, 2001). A3a. Care Management Disparities The institute of medicine has defined health disparities as being a difference in health care quality as related to race, ethnicity, socioeconomic status and geography. Other factors affecting disparities includes the clinical needs and health care assessments that are not due to access-related factors as noted. The expense for these disparities in the U.S. estimate around 1.24 Trillion U.S. Dollars (Graham, 2015). A4. Managed Disease Factors The leading cause for elderly hospitalization today is Congestive Heart Failure. It is recognized as representing economic hardship along with having clinical burden on organizations, and providers who strive to offer an affordable plan of care. Patients and family members are faced with financial, literacy, and care taking challenges as most of the population of patients are elder and in need of their children or others to support their care. This can be debilitating for all involved. Hospital re-admissions today have been noted as being related to co- morbidities, polypharmacy and disabilities associated with CHF (Azad & Lemay, 2014). Financial Resources With the high cost of health care and medications on today, CHF patients may lose economic control over their healthcare. However, there are resources available to support those
ADVANCED INFORMATION MANAGEMENT AND THE APPLICATIO 12 in need of assistance. Depending on the insurance and health services available, organizations
- Fall '18
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