The management of this common heart disease currently suffers from many shortcomings.
- In France, nearly 1.5 million patients are affected by heart failure, mostly people over the age of 60 for whom it is the leading cause of hospitalization.
- The context of aging populations should therefore increase the needs and demand for care by 2040.
To improve the care of the many patients suffering from heart failure, doctors, learned societies and patient associations worked together for six months.
4 areas of improvement
As a result of this teamwork, 4 areas for improvement were proposed:
1/ Systematize the early detection of heart failure and its comorbidities, by encouraging preventive actions to limit decompensation. “Among the actions proposed, access to CPAM data in order to better identify and monitor the patients most at risk, the creation of an individual heart failure booklet, the organization of national and local awareness campaigns heart failure aimed at both the general public and health professionals”say the experts.
2/ Optimizing pathways around territorial sectors, in order to best adjust to patient needs and available resources. “This requires, in particular, to adapt the course at the level of each territory, to optimize the City-Hospital/Clinic links by designating a privileged interlocutor, to create a standard coordination model articulated around the roles of the city-hospital cardiologist, the geriatrician, the general practitioner, the pharmacist, the nurse and to develop e-health”, say health professionals.
3/ Improve the sharing of information to limit the loss of chances of access to care. “This involves, among other things, the structuring of information systems at the national and regional level, in particular through the development of data centralization platforms”, judge the different actors. And to continue: this also goes through “the improvement and rationalization of territorial communication and coordination systems; the enhancement and promotion of good practices through initiatives such as a “CI Observatory”, a “CI Prize” or dedicated regional highlights”.
4/ Make course funding a success for patients and caregivers. “This requires adapting funding to the entire pathway so that it covers the management of all care, but also ensuring that financial resources are better allocated and that care resources are used. more efficiently, argues the collective. To achieve these objectives, one of the solutions proposed is to rely on concrete indicators, such as the number of hospitalizations avoided. The actors behind the Optim’IC program also propose to promote those who work to improve the quality of patient care through financial incentives.
Often late diagnosis
The exchanges made it possible to make several observations on the current care model, including: an often late diagnosis of heart failure generally occurring following decompensation, mainly hospital care mobilizing significant resources, access limited to the patient’s clinical history, coordination of care between hospital medicine and community medicine to be optimised, insufficient conditions for patient involvement in their own care.
Each year, heart failure is responsible for approximately 70,000 deaths and 165,000 hospitalizations, which are followed by numerous rehospitalizations which impact the quality of life of patients and generate considerable health expenditure. It now represents 2.8 billion euros in annual expenditure (ie 1.37% of total health expenditure). Hospitalization is the leading item of expenditure, while heart failure accounts for half of potentially avoidable rehospitalizations.
Heart failure is the inability of the heart muscle to normally perform its role of propelling blood through the body. It can occur in the evolution of a myocardial infarction, angina pectoris, arterial hypertension… Its frequency increases with age.
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