Impact of a community-based cardiovascular disease service intervention in a highly deprived area

Heart. 2020 Mar;106(5):374-379. doi: 10.1136/heartjnl-2019-315047. Epub 2019 Aug 22.

Abstract

Objective: To examine the effects on emergency hospital admissions, length of stay and emergency re-admissions of providing a consultant-led, community-based cardiovascular diagnostic, treatment and rehabilitation service, based in a highly deprived area in the North West of England.

Methods: A longitudinal matched controlled study using difference-in-differences analysis compared the change in outcomes in the intervention population, to the change in outcomes in a matched comparison population that had not received the intervention, 5 years before and after implementation. The outcomes were emergency hospitalisations, length of inpatient stay and re-admission rates for cardiovascular disease (CVD).

Results: Findings show that the intervention was associated with 66 fewer emergency CVD admissions per 100 000 population per year (95% CI 22.13 to 108.98) in the post-intervention period, relative to the control group. No significant measurable effects on length of stay or emergency re-admission rates were observed.

Conclusion: This consultant-led, community-based cardiovascular diagnostic, treatment and rehabilitation service was associated with a lower rate of emergency hospital admissions in a highly disadvantaged population. Similar approaches could be an effective component of strategies to reduce unplanned hospital admissions.

Keywords: cardiac rehabilitation; chronic coronary disease; healthcare delivery; heart failure; quality and outcomes of care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiovascular Diseases / therapy*
  • Community Health Services*
  • Emergency Service, Hospital / statistics & numerical data
  • England
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Longitudinal Studies
  • Male
  • Medically Underserved Area*
  • Middle Aged