Health and Medical News and Resources

General interest items edited by Janice Flahiff

[press release] Reducing Hospital Readmission Rates Will Require Community-Focused Effort

From the Wiley press release (February 2015)

Recent research indicates that most of the variation in hospital readmission rates in the United States is related to geography and other factors over which hospitals have little or no control. Access and quality of care outside of the hospital setting seem to be especially important.

A new editorial that addresses these findings notes that a broader focus on community health systems, not just performance of individual hospitals, may be needed to reduce hospital readmissions.

Because high readmission rates trigger reductions in Medicare reimbursements to hospitals, facilities in socioeconomically disadvantaged and underserved communities may be disproportionately penalized. The editorial is published in Health Services Research.

Access and quality outside the hospital may affect the degree to which the HRRP can achieve its intended outcome, fewer readmissions, but other factors are likely to determine whether the policy is an operational success. For the HRRP, operational success could be defined as whether hospitals respond in a manner consistent with the underlying motivations of improving quality of care and reducing costs. In terms of improving quality, a recent meta-analysis of randomized trials found that interventions designed to prevent readmissions tended be moderately effective (relative risk of 30-day readmission 0.82, 95 percent CI, 0.73–0.91). The studied interventions addressed care both during and after hospitalization, such as through case management, patient education, home visits, and patient self-management support, among other activities. Multifaceted interventions were more common and were 30–40 percent more effective than one-dimensional ones (Leppin et al. 2014), yet they may also be more challenging to implement and more costly. The degree to which hospitals nationwide are implementing quality improvement interventions that target readmissions does not appear to have been described.

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February 5, 2015 - Posted by | health care | , , ,

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