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Cedars-Sinai Medical Center Among Group of Leading California Medical Institutions

Awarded Grant to Reduce Hospital Readmission for Heart Failure

Los Angeles - Oct. 6, 2010 - Cedars-Sinai Medical Center will participate in a pioneering study to identify how to help patients navigate the transition to outpatient care after they are discharged from the hospital. The study, which will focus on heart failure patients, is part of a national effort to reduce preventable readmissions to hospitals.

The study will be conducted at Cedars-Sinai, UCLA, UC Davis, UC Irvine, UC San Diego and UC San Francisco and will be funded by a $9.9 million grant from the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality(AHRQ).

The three-year study, “Variations in Care: Comparing Heart Failure Care Transition Intervention Effects,” is part of AHRQ’s major national initiative that seeks to improve quality and reduce the cost of medical care.

“Our goal is to improve quality and reduce costs of care in ways that will improve health care delivery not only at the centers participating in the study, but also at medical centers in communities across the country,” said Michael Langberg, M.D., Cedars-Sinai chief medical officer and senior vice president of Medical Affairs.

Heart failure patients have high rates of hospital readmissions, and the period immediately after they are discharged from the hospital is crucial in preventing readmissions. This project will compare two approaches: managing the transition from inpatient to outpatient care via telephone follow-up by nurse practitioners, and managing the transition from inpatient to outpatient care via wireless remote monitoring backed up by nurse practitioners. These two approaches will be compared with the hospitals’ standard processes for patient discharge.

“Because the data will come from several institutions, it will provide meaningful insights into how to best serve these patients,” Langberg said. “Interventions that are tested in real-world settings are crucial if we want to create a new paradigm of health care delivery.”

This project builds on a study of variations in health care resource use and outcomes among heart failure patients from Cedars-Sinai and the five UCs, published last year in the journal Circulation: Cardiovascular Quality and Outcomes.  That study found that six-month mortality rates were lower for elderly Medicare heart failure patients hospitalized at centers that used more health care resources, compared with those at hospitals that used fewer resources. These findings suggested that more resource-intensive care may improve outcomes among certain patients with heart failure, the most frequent cause of hospitalization and death among Medicare beneficiaries.

The award is part of $473 million in AHRQ grants and contracts that support projects to help people make health care decisions based on the best evidence of effectiveness. The awards are part of the investments made under the American Recovery and Reinvestment Act of 2009, which included $1.1 billion to support patient-centered outcomes research, also known as comparative effectiveness research. These efforts encompass many areas, including health care interventions in real world settings, advanced use of the research findings by diverse populations, development of effective patient registries, and training and career development for the next generation of researchers.

The Cedars-Sinai research team is led by Bruce Davidson, Ph.D., director, Department  of Resource and Outcomes Management (ROM) and includes Jeanne Black, Ph.D., manager of Health Policy Research in ROM and Asher Kimchi, M.D, vice clinical chief of the Division of Cardiology. Elizabeth Zellmer, M.P.A., ROM, senior health policy research analyst, is project manager.