Frank Laws, MD

Heart failure (HF) is a complex clinical syndrome in whichthe heart is unable to deliver adequate cardiac output at normal fillingpressures. There are proven pharmacological and clinical management strategiesthat can improve care and reduce associated health care costs, but these areunderutilized. The Advanced Heart Failure Program (AHFP) was developed at theDorn Veterans Administration Medical Center to provide a comprehensivemultidisciplinary management approach to persons with advanced HF. Beforeenrollment in the AHFP, the average annual all-cause hospital admission rate was3.2 for the 217 HF patients. After enrollment in the AHFP and stabilization, themean all-cause hospital admission rate was 1.2. HF patients had an averageannual hospitalization cost of $28,936.32 before enrollment in the AHFP. Afterenrollment, average hospitalization cost dropped to $10,851.12 per patient.Taking into account the 50-week cost of $3036.14 for a patient enrolled in theclinic, participation in the AHFP was associated with a significant decrease inthe number of HF-related admissions, saving an average of $15,049.06 perpatient. (Drug Benefit Trends. 2008;20:54-59)