Effect of post-hospital discharge telephonic intervention on hospital readmissions in a privately insured population in Australia

Abstract

Objective. The aim of the present study was to evaluate the effect of telephone support after hospital discharge to reduce early hospital readmission among members of the disease management program My Health Guardian (MHG) offered by the Hospitals Contribution Fund of Australia (HCF).Methods. A quasi-experimental retrospective design compared 28-day readmissions of patients with chronic disease between two groups: (1) a treatment group, consisting of MHG program members who participated in a hospital discharge (HODI) call; and (2) a comparison group of non-participating MHG members. Study groups were matched for age, gender, length of stay, index admission diagnoses and prior MHG program exposure. Adjusted incidence rate ratios (IRR) and odds ratios (OR) were estimated using zero-inflated negative binomial and logistic regression models respectively.Results. The treatment group exhibited a 29% lower incidence of 28-day readmissions than the comparison group (adjusted IRR 0.71; 95% confidence interval (CI) 0.59-0.86). The odds of treatment group members being readmitted at least once within 28 days of discharge were 25% lower than the odds for comparison members (adjusted OR 0.75; 95% CI 0.63-0.89). Reduction in readmission incidence was estimated to avoid A$713 730 in cost.Conclusions. The HODI program post-discharge telephonic support to patients recently discharged from a hospital effectively reduced the incidence and odds of hospital 28-day readmission in a diseased population.What is known about the topic? High readmission rates are a recognised problem in Australia and contribute to the over 600 000 potentially preventable hospitalisations per year. What does this paper add? The present study is the first study of a scalable intervention delivered to an Australian population with a wide variety of conditions for the purpose of reducing readmissions. The intervention reduced 28-day readmission incidence by 29%. What are the implications for practitioners? The significant and sizable effect of the intervention support the delivery of telephonic support after hospital discharge as a scalable approach to reduce readmissions.

Nurse‐led postdischarge telephone follow‐up calls: A mixed study systematic review

“…Telephone follow‐up is perceived as a positive intervention conducted by a variety of hospital‐based personnel to exchange information, provide aftercare advice, to manage symptoms, to aid early recognition of complications, and as a means of providing reassurance and easing the transition from hospital to home (Mistiaen & Poot, ). TFU is also advocated as a cost‐effective measure to improve patient health outcomes, increase patient satisfaction and reduce unplanned readmissions (Gonçalves‐Bradley et al, 2017; Hamar et al, ).…”

Calling for confirmation, reassurance, and direction: Investigating patient compliance after accessing a telephone triage advice service

“…Investigating ED appropriate care for these cohorts enabled a comparative view of TTAS's influence toward clinically safe and efficient care. Consistent with previous reporting of ED appropriate care and recognizing the high prevalence of readmission in Australia, attendance was assessed as appropriate when patients were: triaged into categories 1, 2, or 3, admitted to hospital, or had been admitted recently.…”

Predicting all‐cause unplanned readmission within 30 days of discharge using electronic medical record data: A multi‐centre study

“… 1 Readmissions in Australia contribute to more than 600 000 potentially avoidable hospitalisations each year. 2 In the United States, potentially avoidable 30‐days readmissions cost Medicare more than US$17 billion annually. 3 Several attempts have been made to quantify the risk of unplanned readmission in specific patient populations including disease‐specific, age‐specific, and intensive care unit (ICU) patients.…”

“…A systematic review estimated around a quarter (range 5.0%‐78.9%) of readmissions to medical, surgical, and geriatric services as potentially avoidable 1 . Readmissions in Australia contribute to more than 600 000 potentially avoidable hospitalisations each year 2 . In the United States, potentially avoidable 30‐days readmissions cost Medicare more than US$17 billion annually 3 .…”