often characterized by progressive deterioration and frequent hospital
admissions. Annual expenditures for heart failure have
been estimated to be as high as $38 billion, of which $23 billion
is for hospital stays (2). For Medicare alone, the heart failure
costs exceed the costs for myocardial infarction or all types of
cancer combined. The incidence of hospital admission for
heart failure is increasing rapidly (3), and readmissions for
heart failure occur within months of the index hospital period
for over 30% of patients. Readmission costs consume a
proportional share (30%) of the overall inpatient costs, and
even more in patients with the greatest degree of chronic
functional impairment.