{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T21:56:16Z","timestamp":1769637376690,"version":"3.49.0"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T00:00:00Z","timestamp":1718323200000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There is no widely accepted care model for managing high\u2010need, high\u2010cost (HNHC) patients. We hypothesized that a Home Heart Hospital (H3), which provides longitudinal, hospital\u2010level at\u2010home care, would improve care quality and reduce costs for HNHC patients with cardiovascular disease (CVD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate associations between enrollment in H3, which provides longitudinal, hospital\u2010level at\u2010home care, care quality, and costs for HNHC patients with CVD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective within\u2010subject cohort study used insurance claims and electronic health records data to evaluate unadjusted and adjusted annualized hospitalization rates, total costs of care, part A costs, and mortality rates before, during, and following H3.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ninety\u2010four patients were enrolled in H3 between February 2019 and October 2021. Patients' mean age was 75 years and 50% were female. Common comorbidities included congestive heart failure (50%), atrial fibrillation (37%), coronary artery disease (44%). Relative to pre\u2010enrollment, enrollment in H3 was associated with significant reductions in annualized hospitalization rates (absolute reduction (AR): 2.4 hospitalizations\/year, 95% confidence interval [95% CI]: \u22120.8, \u22124.0; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001; total costs of care (AR: \u2212$56\u2009990, 95% CI: \u2212$105\u2009170, \u2212$8810; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05; and part A costs (AR: \u2212$78\u2009210, 95% CI: \u2212$114\u2009770, \u2212$41\u2009640; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Annualized post\u2010H3 total costs and part A costs were significantly lower than pre\u2010enrollment costs (total costs of care: \u2212$113\u2009510, 95% CI: \u2212$151\u2009340, \u2212$65\u2009320; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001; part A costs: \u2212$84\u2009480, 95% CI: \u2212$121\u2009040, \u2212$47\u2009920; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Longitudinal home\u2010based care models hold promise for improving quality and reducing healthcare spending for HNHC patients with CVD.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.24302","type":"journal-article","created":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T11:11:20Z","timestamp":1718363480000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Home Heart Hospital Associated With Reduced Hospitalizations and Costs Among High\u2010Cost Patients With Cardiovascular Disease"],"prefix":"10.1002","volume":"47","author":[{"given":"Michael","family":"Shen","sequence":"first","affiliation":[{"name":"Novolink Health (Previously Duxlink Health) A Division of Cardiovascular Associates of America Sunrise Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8199-7476","authenticated-orcid":false,"given":"Kareem","family":"Osman","sequence":"additional","affiliation":[{"name":"University of California Los Angeles David Geffen School of Medicine, Department of Medicine Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9321-6537","authenticated-orcid":false,"given":"Daniel M.","family":"Blumenthal","sequence":"additional","affiliation":[{"name":"Novocardia A Division of Cardiovascular Associates of America Celebration Florida USA"},{"name":"Cardiology Division Massachusetts General Hospital Boston Massachusetts USA"},{"name":"Harvard Medical School Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaelin","family":"DeMuth","sequence":"additional","affiliation":[{"name":"Philadelphia College of Osteopathic Medicine South Georgia Moultrie Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yixiang","family":"Liu","sequence":"additional","affiliation":[{"name":"Novolink Health (Previously Duxlink Health) A Division of Cardiovascular Associates of America Sunrise Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,6,14]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.20.2.9"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.18171"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1608511"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.17029"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa1906848"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa2033678"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.13674"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.13774"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2018.2562"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-043285"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy565.1107"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(22)03040-6"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(22)01185-8"},{"key":"e_1_2_10_15_1","unstructured":"\u201cHealth Department of Comprehensive Critical Care: A Review of Adult Critical Care Services [Internet]\u201d. 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