IMPACT OF INPATIENT PULMONARY MEDICINE CONSULTATION FOR COPD EXACERBATION ON 90-DAYS AND 1-YEAR HOSPITAL READMISSION RATES

Background: Heart failure (HF) hospitalization rates have remained high in the past 10 years. Numerous studies have shown significant improvement in HF readmission rates when pharmacists or pharmacy residents conduct postdischarge telephone calls. Objective: The purpose of this retrospective review of a pilot program was to evaluate the impact of pharmacy student–driven postdischarge phone calls on 30- and 90-day hospital readmission rates in patients recently discharged with HF. Methods: A retrospective manual chart review was conducted for all patients who received a telephone call from the pharmacy students. The primary endpoint compared historical readmissions, 30 and 90 days prior to hospital discharge, with 30 and 90 days post discharge readmissions. For the secondary endpoints, historical and postdischarge 30-day and 90-day readmission rates were compared for patients with a primary diagnosis of HF and for patients with a secondary diagnosis of HF. Descriptive statistics were calculated in the form of means and standard deviations for continuous variables and frequencies and percentages for categorical variables. Results: Statistically significant decrease was observed for both the 30-day ( P = .006) and 90-day ( P = .007) readmission periods. Prior to the pharmacy students’ phone calls, the overall group of 131 patients had historical readmission rates of 24.43% within 30 days and 38.17% within 90 days after hospital discharge. After the postdischarge phone calls, the readmission rates decreased to 11.45%, for 30 days, and 22.90%, for 90 days. Conclusion: Postdischarge phone calls, specifically made by pharmacy students, demonstrated a positive impact on reducing HF-associated hospital readmissions, adding to the growing body of evidence of different methods of pharmacy interventions and highlighting the clinical impact pharmacy students may have in transition of care services.

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Using hospital readmission rates to track the quality of care in public hospitals in Singapore

BMC Health Services Research ◽

10.1186/1472-6963-11-s1-a16 ◽

2011 ◽

Vol 11 (S1) ◽

Cited By ~ 12

Author(s):

E Lim ◽

N Matthew ◽

W Mok ◽

S Chowdhury ◽

D Lee

Keyword(s):

Quality Of Care ◽

Hospital Readmission ◽

Public Hospitals ◽

Readmission Rates ◽

Hospital Readmission Rates

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Abstract 169: Targeting Patients with Multiple Readmissions in the Year after Non-ST-Elevation Myocardial Infarction Could Lower Hospital Readmission Rates

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.6.suppl_1.a169 ◽

2013 ◽

Vol 6 (suppl_1) ◽

Author(s):

Gwen Bernacki ◽

Karen Alexander ◽

Matthew Roe ◽

Shuang Li ◽

Laine Thomas ◽

...

Keyword(s):

High Risk ◽

Hospital Readmission ◽

Transitional Care ◽

Multivariable Analysis ◽

Patient Characteristics ◽

High Risk Group ◽

Billing Data ◽

Readmission Rates ◽

Bundled Payment ◽

Hospital Readmission Rates

Background: Bundled payment policies have focused on 30-day readmission rates after AMI, yet these are likely to lengthen over time. Identifying patients with multiple readmissions in the year after AMI could help focus transitional care efforts on these high risk patients. Methods: Data from the CRUSADE registry linked to Medicare billing data was used to examine longitudinal outcomes of 32,776 NSTEMI patients ≥ 65 years between 2003 and 2006 with 12-month follow-up. Defining frequent readmissions as ≥3 hospitalizations in 12 months, we compared characteristics of patients frequently readmitted vs. not. The association between frequent readmissions and patient characteristics was examined using multivariable logistic regression. Results: Readmission within 12 months after NSTEMI occurred: once (N=8,830, 26.9%); twice (N=4334, 13.2%); 3 times (N=2,319, 7.1%); ≥4 times (N=2470, 7.5%). Those with multiple (≥3) readmissions (14.6%) were older with recent prior hospitalization and greater prevalence of comorbidities. In multivariable analysis, these factors increased discrimination of patients with frequent readmissions, (c-statistic=0.714). Conclusions: Comorbidities and recent prior hospitalization can predict patients with frequent readmissions. Better understanding of the influence of these clinical factors in this high-risk group presents an opportunity to lower hospital readmission rates.

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Abstract 14996: Healthcare Resource Utilization and Costs in Congestive Heart Failure 90-day Episodes Within the Bundled Payment for Care Initiative (BPCI) Model 2, 2016-2018

Circulation ◽

10.1161/circ.142.suppl_3.14996 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Xian Shen ◽

Gabriel Sullivan ◽

Mark Adelsberg ◽

Martins Francis ◽

Taylor T Schwartz ◽

...

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Hospital Stay ◽

Hospital Readmission ◽

Hospital Readmissions ◽

Angiotensin Receptor ◽

Post Discharge ◽

Readmission Rates ◽

Hospital Readmission Rates ◽

Initial Hospital

Introduction: Congestive heart failure (HF) is the fourth most commonly selected clinical episode among Model 2 participants of the Medicare Bundled Payments for Care Improvement (BPCI) Initiative. This study describes utilization of pharmacologic therapies, hospital readmission rates, and HF episode costs within the BPCI framework. Methods: The 100% sample of Medicare FFS enrollment/claims were used to identify acute hospital stays with a MS-DRG 291/292/293 between 1JAN2016 and 31DEC2018. A HF episode consisted of the initial hospital stay and all Part A & B covered services up to 90-days post-discharge. Prescription fills for angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), or angiotensin receptor-neprilysin inhibitors (ARNI) during the 90 days post-discharge were captured. Rates of all-cause and HF readmissions were reported per 10,000 episodes during the 30-, 60-, and 90-days post-discharge period. Total episode costs were defined as the sum of Medicare payments for the initial hospital stay plus all Part A & B covered medical services in the 90-day post-discharge. Results: The sample included 634,307 HF episodes. Patients received ARNIs in 3%, ACEIs/ARBs in 45%, and neither in 52% of the episodes, respectively. All-cause hospital readmission rates were 2,503, 4,465, and 6,368 per 10,000 episodes during the 30-, 60-, and 90-day periods. The 30-, 60-, and 90-day HF readmission rates were 958, 1,696, and 2,394 per 10,000 episodes. Total mean 90-day episode cost was $20,122, of which $8,002 was attributable to hospital readmissions. Conclusions: Hospital readmissions are frequent for HF patients and contribute a notable proportion of overall HF BPCI episode costs. BPCI participants may consider improving utilization of guideline directed medical therapies for HF, including ACEIs/ARBs and ARNI, as a strategy for reducing hospital readmissions and associated costs.

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