Heart Failure's First Shock and Nurse-Led Chronic Care

Moslem Rashidi, Luke B. Connelly and Gianluca Fiorentini

Papers from arXiv.org

Abstract: We study how a first heart-failure hospitalization, an adverse health shock, changes patients' care, and whether a nurse-led chronic-care program sustains those post-shock investments. Using linked population-wide administrative records from Italy's Romagna Local Health Authority (2017-2023), we anchor event time at each patient's first CHF admission and exploit staggered timing to estimate dynamic effects. The shock triggers a sharp post-discharge surge: beta-blocker adherence, cardiology follow-up, and echocardiography rise immediately, while emergency-room use spikes just before admission and then stabilizes. We then estimate the incremental impact of enrollment in the Nurse-led Program for Chronic Patients (NPCP) using the interaction-weighted event-study estimator for staggered adoption. Under conventional difference-in-differences inference, NPCP strengthens long-run preventive engagement, with little detectable change in emergency-room use. HonestDiD sensitivity analysis indicates these gains are economically meaningful but not statistically definitive under modest departures from parallel trends.

Date: 2026-03
New Economics Papers: this item is included in nep-hea
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