Seminar The Impact of Nurse-Led Chronic Care on Health Behaviors and Acute Care Use After First Heart Failure Hospitalization

We study whether nurse-led programs for chronic patients (NPCPs) improve secondary prevention among individuals with congestive heart failure (CHF). Using linked administrative data on 15{,}703 patients in Emilia--Romagna, Italy (2017--2023), we anchor event time at the calendar quarter of each patient’s first CHF hospitalization and estimate dynamic effects in a staggered-adoption event-study with the interaction-weighted (IW) estimator. Six or more quarters after the index hospitalization, point estimates suggest modest gains: $\beta$-blocker adherence rises by about 3 percentage points, specialist cardiology visits by 7–8 per 100 patient-quarters, and echocardiograms by 4–5 per 100; emergency-room visits show no clear change. Improvements are larger for women, older patients, and those with lower comorbidity. Under conservative uniform sensitivity bands (HonestDiD), most estimates are imprecise and often not statistically distinguishable from zero. We therefore read the evidence as suggestive: structured nurse-led care may foster small, longer-run improvements in preventive behaviors after a major adverse health shock, while leaving emergency use unchanged on average.