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arXiv · 2603.23024

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

Moslem Rashidi·Luke B. Connelly·Gianluca Fiorentini
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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.

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Moslem Rashidi, Luke B. Connelly, Gianluca Fiorentini. 2026-03-24. Heart Failure's First Shock and Nurse-Led Chronic Care. https://arxiv.org/abs/2603.23024

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