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both the patient and the family both emotionally and financially. Knowledge, self-motivation, and family support is key to having quality of life with heart failure.Community: My community is made up of the 4 ethnic groups reported with the highest heart failure risks. Caucasian, non-Hispanic makes up 58.4% of my community, while African American is 26.2%, Hispanic is 5.62%, and Asian is 5.44%, of the population (Peoria, 2015). Per Peoria IL, there are reportable 155 cases of heart failure that are enrolled in Medicare seeking hospital treatment (2015). The medical centers re-admission rate for this population is 19.1% and mortality rate 30 days after an admission is 12.6%. Both are reportable to CMS and JACHO for quality indicators. This affects reimbursement from Medicare as there is a penalty for all heart failure readmission. Placing not only an economic burden nationally but also within my community. It affects the bottom line of the medical center, when quality indicators are not met and reimbursement for care provided is not rendered. In my community, heart failure is a core measure. When a patient is hospitalized with heart failure, education regarding the disease and treatment regimen begin on the day of admission. Education is provided using teach back method, to engage patient and family in their plan of care. Case Management is consulted to follow the patient throughout the hospital stay to ensure patient and family psychosocial,
Pathopharmacological Foundation 22financial, access to medical treatment is available. In addition case management arranges at discharge a primary care visit within the first 5 days, and that patient and family have adequate resources and transportation to the appointment. Align patient and family with the Heart Failure clinic for management, education, and maintenance of their disease. Heart failure is a communityneed, physician, medical centers, patient and healthcare workers must be engaged to patient’s plan of care to be successful and improve patient’s outcomes. CostsAccording to the AHA, the total cost for heart failure in 2012 was estimated to be 30.7 billion dollars and costs will continue to rise as the population continues to age with the advancesin medical treatment. Heart failure accounts for 1-2% of overall healthcare costs. While the mostexpensive cost is hospitalization and accounts for 65-70% of total heart failure costs (Dunlap, Shah, Shi, Morlan, VanHouten, Hall Long, & Roger, 2011). It is reported that most of the costs accrue during initial diagnosis phase of heart failure and then again at the end of life. Average lifetime cost per patient with heart failure is 95,000 dollars (Dunlap et al, 2011). The breakdown looks at inpatient hospitalization costs around 75,000 dollars per patient and outpatient costs around 22,000 dollars per patient (Dunlap et al, 2011). Evaluation and management of heart failure is reported to cost on average of 13,000 dollars per patient, which accounts for office visits, laboratory testing, and procedures from initial diagnosis till end of life (Dunlap et al, 2011). Echocardiograms account for 20.8% of outpatient costs. While imaging such as CT scan and MRI is 29.6% of overall costs.
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Nursing, diastolic heart failure, Pathopharmacological Foundation