Specialists Improve Heart Care

Outpatient care involving both a specialist and a family doctor was associated with a 66% drop in the risk of one-year mortality.

"Unfortunately, we found that patients who were elderly and living in rural areas had less access to specialty care,” noted Dr. Paul Armstrong, professor of medicine in the division of cardiology at the University of Alberta (Canada) and one of the study's authors. "We now know that only a minority of heart failure patients are seen in specialty heart failure clinics where it has been shown that outcomes are improved.”

The population-based study followed 3,136 patients who were newly diagnosed with congestive heart failure and had just been discharged from various hospitals. Of these, 34% received no follow-up visits for cardiovascular care, 24% were seen by a family doctor alone, 1% by a specialist, and 42% by both a family doctor and a specialist. The study showed that compared with patients who received no follow-up care, patients who received regular cardiovascular follow-ups with a specialist had 38% fewer visits to the emergency room, only 13% were readmitted to the hospital, and the one-year mortality rate was lower: 22% vs 37%.

Patients who have follow-up care from both specialists and family doctors are in better health because they have more contacts with the medical community, Dr. Armstrong said. "There are more opportunities for deterioration in status to be detected, for medications to be altered, and for therapies to be reinforced.”




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