Primary Outcome Measures:
- The time from hospital discharge to first hospital readmission or death. [ Time Frame: basline and 1 month ]
The primary endpoint will be assessed as a continuous variable. Survival curves will be produced using Kaplan-Meier analysis for both the CHF Disease Management Group and the case control group. A Cox regression-based test will be used to test differences in survival between the CHF Disease Management Group and the case control group. If case control subjects cannot be exactly matched on covariates to CHF Disease Management subjects, inverse probability of treatment weights (obtained via logistic regression) will be applied to correct for covariate imbalances between the two groups.
Secondary Outcome Measures:
- The time from hospital discharge to unplanned hospital admission for acute decompensated heart failure. [ Time Frame: baseline and 3 months ]
3 months minus baseline
- Change in quality of life. [ Time Frame: baseline and 2 months ]
Kansas City Living with Cardiomyopathy Questionnaire will be analyzed using a paired t-test comparing baseline and 2 month scores.
- Mean readmission cost for each patient for total cost for each readmission. [ Time Frame: baseline and 3 months ]
Average costs for the medical management group versus the disease management group will be calculated.
- Improvement in knowledge of Heart Failure [ Time Frame: baseline and 2 months ]
Atlanta Heart Failure Knowledge Test baseline score minus 2 month score