Telephonic outreach by health plan case managers within 24 hours of hospital discharge reduced future readmissions by 22 percent, according to a study from Cigna, which was published in the American Journal of Managed Care.
The study of 3,988 high-risk gastrointestinal, heart and lower respiratory patients found that prioritized outreach following hospital discharge resulted in more physician visits and prescription drug fills following initial discharge, and significantly reduced 60-day readmissions rates. Critical to the intervention was the timing and prioritizing of the calls, and the risk severity of the patients, researchers noted.
Readmissions of high-risk patients account for an estimated 30 percent of total inpatient costs, the report continues. High-risk is defined as patients initially diagnosed with gastrointestinal, heart or lower respiratory illness, and having to stay in the hospital for three days or more.
Researchers conducted a treatment group of 1,994 patients, who received telephonic outreach and engagement within 24 hours of discharge, and calls based on risk order, with the highest risk patients receiving calls first. A control group of 1,994 patients received delayed telephonic outreach and engagement 48 hours after discharge notification; calls were made with no attention to risk factors.
The study found that the 60-day readmission rate for the treatment group was 7.4 percent, versus 9.6 percent for the control group, representing a 22 percent reduction in all-cause readmissions.
Healthcare organizations providing post-discharge telephonic outreach to patients with diagnoses related to heart, gastrointestinal and lower respiratory can use these findings to inform the alignment of their case management resources, Cigna officials said. But further study needs to be done with patients of all major diagnoses, to see if this intervention is successful for a wider profile of patients.
Source: Cigna, January 2, 2013
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