Impact of the Swedish Care Coordination Act on Heart Failure Readmissions and Length of Stay
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Patients with heart failure tend to experience higher rates of hospital readmissions compared with other ambulatory care-sensitive conditions. In Sweden, the nationwide Care Coordination Act (CCA) was introduced in January 2018 with the goal of improving care coordination, resulting in a reduction of readmissions and length of stay. There is insufficient knowledge regarding the effect of this reform on patients with heart failure. METHODS: code I50 (Heart Failure). The data set included all admissions with a primary diagnosis of heart failure among elderly, multimorbid patients between 2015 and 2019. An interrupted time series analysis using hierarchical mixed models with random effects clustered at the hospital ward level was conducted. RESULTS: A total of 111 414 admissions were included. The average readmission rate for patients with heart failure was 26.8% before and 26.7% after the CCA. The average length of stay was 8.4 days before the CCA and 8.1 days after. Mortality within 30 days was 7.3% before the CCA and 7.5% after. There were no significant differences between the periods before and after. In an analysis assessing the overall linear time trend 2 of 21 regions showed a reduction in readmissions and 10 in length of stay. CONCLUSIONS: After introducing the CCA, no detectable impact was found on readmissions or mortality for patients with heart failure, which is in line with previous studies, such as those studying the US Hospital Readmission Reduction Program. Although no overall association with length of stay could be identified, it was reduced in several Swedish regions. The heterogeneity between regions could be used to understand the specific components needed to achieve the reduction of readmissions in future studies.
Source: Circulation Heart Failure
Institution: Uppsala University
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4415729138