Quality improvement programs targeting hospital readmission rates often are effective, but lowering those rates does not always result in significant cost savings, according to a study published Tuesday in JAMA Internal Medicine.
For the study, researchers from several institutions—including Cedars-Sinai Medical Center, Virginia Polytechnic Institute and State University, University of California, Los Angeles, and the RAND Corporation—conducted a systemic review and meta-analysis of 50 studies on quality improvement programs, which included more than 16,700 patients.
The majority of the studies the researchers reviewed spanned between six and 24 months, but 15 were conducted over a period of 30 days.
The researchers found quality improvement programs are effective tools for reducing readmissions, but such interventions do not consistently provide financial benefits for health systems. According to the study, net costs and savings varied widely after systems implemented quality improvement programs.
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Based on their analysis, the researchers found readmissions decreased by an average of:
- 12 percent for patients with heart failure; and
- 6.3 percent for patients in the general population.
Health systems in those studies on average reported economic effects that ranged from net savings of $972 per patient among the heart failure population to net losses of $169 per patient among the general population.
The researchers said in general populations the most cost-effective programs involved engaging patients and caregivers. Specifically, health systems reported net costs that were $8,282 lower when they implemented programs centered on patient and caregiver engagement, compared with when they did not implement such interventions, according to the study.
Lead study author Teryl Nuckols, director of Cedars-Sinai Medical Center's division of general internal medicine, said "Hospitalization is very expensive, so avoiding even a few readmissions should have saved a lot of money," but the "findings suggest that there is no guarantee of net cost savings once the implementation costs associated with efforts to prevent readmissions are considered" (AHA News, 5/31; Minemyer, FierceHealthcare, 5/31; Nuckols et al., JAMA Internal Medicine, 5/30).
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Reducing your hospital's readmission rates can seem like an overwhelming task—but it doesn't have to be.
Knowing where to focus is half the battle. We've found that the best strategies target four stages of care with significant potential to influence patient outcomes. The other half is knowing what improvements to make.
That's where our Readmission Reduction Toolkit comes in. We've compiled resources from across Advisory Board that will help you isolate and correct patient and systemic issues in the four critical stages of care:
Stage 2: Discharge education
Stage 3: Post-acute care coordination
Stage 4: Transitional care support