[Impact of a nurse-based XXXX management program on hospitalization rate, functional status, quality of life, and medical costs].

@entity1 @entity712 @entity5856
BACKGROUND: @entity712 is a major health problem for prevalence, morbidity and costs; @entity712 management programs may prevent hospital admissions, improve clinical status and reduce medical costs. METHODS: A care program for @entity712 @entity1 was activated by the Cardiology Department, based on a nurse-monitored outpatient clinic, @entity5856 in cooperation with cardiologists, who were responsible for optimal pharmacological treatment. Nurses provided @entity1 education, monitoring of clinical status and symptoms and verified adherence to pharmacologic and dietary therapy. To assess the impact of the program on hospitalization rate, functional status and quality of life we compared: 1) hospital admission rate for @entity712 in the 6 months before and the 6 months after referral; 2) Minnesota Living with @entity712 Questionnaire (MLHFQ) score and NYHA functional class at referral time and after 6 months. A cost-based analysis was performed to compare the two periods. RESULTS: Between January 1999 and November 2000, 107 @entity1 were followed up for at least 6 months. Hospitalization declined by 70% (57 admissions in the 6 months before referral, 17 in the 6 months afterwards, p = 0.0001). Functional status improved after 6 months: 41 @entity1 were in NYHA class III-IV at referral time, 26 after 6 months. The mean total score of MLHFQ was reduced from 33.9 to 28.7 (p = 0.005). The average cost of the program was estimated to be [symbol: see text] 218 (Itl 423,000) per @entity1 in 6 months. The savings in overall cost of care was [symbol: see text] 615 (Itl 1,192,000) per @entity1 in 6 months. CONCLUSIONS: A management program based on a nurse-monitored outpatient clinic can reduce hospitalization rate, improve functional status and quality of life and decrease medical costs for @entity712 @entity1 's care.
