Policy, Payment & Practice -> Clinical Quality Measures and Outcomes D-PO03 - Poster Session III (ID 48) Poster

D-PO03-120 - Evaluation Of Admission Rates After Rapid Follow Up At A Dedicated Center For Atrial Fibrillation (ID 1109)


Background: Atrial fibrillation (AF) affects millions of Americans each year and can lead to high levels of resource utilization through emergency department (ED) visits and inpatient stays.
Objective: To evaluate the impact of a dedicated Center for AF in reducing inpatient admissions after referrals for new AF.
Methods: The UPMC Center for AF serves as a rapid referral center for patients with AF to avoid unnecessary inpatient admissions from the emergency department and as a resource for specialized care through outpatient referral. Patients receive a comprehensive education by an advanced practice nurse and a treatment plan is developed in collaboration with an electrophysiologist to achieve consistent standardized care. Patients that presented to the ED or outpatient setting with AF and met prespecified clinical criteria (hemodynamically stable, pulse<110, O2 saturation>95%, no concomitant illness) were directed to rapid outpatient follow up instead of inpatient admission. ED patients and outpatients directed to the Center for AF were compared to matched controls for 30-day cardiology admissions and subsequent 30-day ED visits. Comparisons were made using McNemar’s Chi-Square test.
Results: A total of 298 patients (mean age: 65.4 ± 14.3, 38.4% female) that presented between 2015-2019 were analyzed in this study. 149 patients followed up with the Center for AF after ED visit for new AF or rapid outpatient referral from 2017-2019 and were compared with 149 historical matched controls from 2015-2017. 30-day cardiology admissions for patients following up with the Center for AF were significantly lower (8 vs. 69, p < 0.001) and were driven by 67 control patients admitted after initial ED presentation. 30-day cardiology-related ED visits were similar (8 vs. 9, p = 1.0).
Conclusion: Directing patients with AF to follow up at a dedicated Center for AF significantly reduced inpatient admissions while having no effect on subsequent quantity of cardiology-related ED visits which presumably will have a large impact on the cost of healthcare in this patient population.