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

Author

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  • Moslem Rashidi
  • Luke B. Connelly
  • Gianluca Fiorentini

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.

Suggested Citation

  • Moslem Rashidi & Luke B. Connelly & Gianluca Fiorentini, 2026. "Heart Failure's First Shock and Nurse-Led Chronic Care," Papers 2603.23024, arXiv.org.
    • Handle: RePEc:arx:papers:2603.23024
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    References listed on IDEAS

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