Strengthening nursing-led support groups to reduce rehospitalization and health costs in heart failure patients: A policy brief

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Abstract
This policy brief aims to identify existing policies related to heart failure management and support group interventions, and also to examine how these policies can be optimized by strengthening the role of nurses in Indonesia. Specifically, it examines the integration of nursing-led support groups into the healthcare system as a strategic approach to reducing hospital readmissions and enhancing patient continuity of care for those with heart failure. A policy analysis approach was used by combining a literature review, synthesis of national regulations, and evaluation of global best practices. The process included identifying critical gaps in current heart failure management policy, assessing the impact of support groups, and formulating evidence-based, context-specific policy recommendations. Key challenges identified include high rates of rehospitalization, increased financial burden on BPJS Kesehatan, caregiver stress, and lack of structured, multidisciplinary post-discharge interventions. The evidence shows that support groups effectively enhance treatment adherence, patient empowerment, and overall quality of life. Moreover, nursing-led initiatives have demonstrated significant potential in improving patient engagement and reducing healthcare disparities in diverse populations. Nurses must play active roles in facilitating peer education and providing psychosocial support to contribute to improved health outcomes and system efficiency. This brief emphasizes the necessity of policy frameworks that empower nurses with adequate training, resources, and authority to lead these groups effectively. Nursing-led support groups offer a cost-effective and scalable approach to reducing rehospitalization and promoting self-care in patients with heart failure. Furthermore, integrating these groups within existing clinical pathways can foster multidisciplinary collaboration, improve data collection for monitoring outcomes, and support sustainable healthcare financing models. This policy brief calls for their integration into clinical pathways, supported by regulation, cross-sector collaboration, and sustainable funding. Nurses, alongside interdisciplinary teams, play a key role in ensuring continuity of care through structured peer support at all levels of service.

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