Successful hospital readmission reduction initiatives: Top five strategies to consider implementing today

Kash, Bita A.; Baek, Juha; Cheon, Ohbet; Coleman, Nana E.; Jones, Stephen L.

doi:10.5430/jha.v7n6p16

Cited by 8 publications

(9 citation statements)

References 15 publications

(26 reference statements)

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“…The detailed information for the studies finding beneficial outcomes in readmission reductions are listed in Table 3. Kash et al [44] Overall, there were significantly reduced admission and readmission rates for patients with the pure CHF diagnosis; 30-day and 90-day readmission rates declined 75% (p = .02) and 74% (p = .004), respectively. Reductions were also seen in total hospital days and emergency room utilization.…”

Section: Resultsmentioning

confidence: 93%

“…A list and description of the interventions aimed toward reducing short-term hospital readmissions can be found in Kash et al's study. [43,44] A breakdown of the number of studies examining various strategies and the number finding beneficial, null, or mixed effects can be found in Table 2.…”

Section: Resultsmentioning

confidence: 99%

“…In examining interventions used, we also distinguished between studies that examined one intervention independently and those that examined bundled interventions (for example studies that examined an intervention that included telephone follow-up, discharge planning, and collaboration among providers). We differentiated interventions based on 12 categories on the basis of existing literature, [43,44] and coded them with the intervention name, description, clinic setting, study design. We additionally gathered information on whether each study found a beneficial association between the intervention(s) under study and short-term readmission (i.e.…”

Section: Methodsmentioning

confidence: 99%

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Interventions aimed at addressing unplanned hospital readmissions in the U.S.: A systematic review

Ferdinand

Cheon

Bako

et al. 2018

JHA

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One of the policy mechanisms aimed at improving population health through health care delivery is the Hospital Readmissions Reduction Program (HRRP) as outlined in the Affordable Care Act. Although numerous procedural and behavioral interventions have been implemented, the empirical evidence of the efficacy of these interventions is mixed and specific to certain patient segments. This review aimed to systematically assess studies of hospital interventions to reduce 30-day readmissions for specific diseases and populations. Following the PRISMA review checklist, searches were conducted from January 2000 to August 2018 in the MEDLINE and EMBASE databases using terms such as “patient readmission”, “readmit” and “re-hospitalization” in conjunction with disease terms such as “asthma”, “chronic obstructive pulmonary disease (COPD)” and “pneumonia”. Of 3,806 articles identified, 45 were included after a 3-step inclusion process. The age group most frequently considered among the studies was the 65 age cohort. Multidisciplinary collaborative interventions were most frequently effective for the subset of elderly, female, Caucasian, and heart failure patients. Interventions involving patient or family education delivered before and after care were most effective for racial minority, elderly, COPD, and heart failure patients. Telephone follow-up, tele-homecare, and medication reconciliation were largely found to be successful in reducing readmissions. Major gaps exist in identifying successful interventions for reducing 30-day readmissions among patients who sought treatment for sepsis, stroke, and replacement of the hip or knee. Our findings indicate an opportunity for researchers to further study, and for healthcare organizations to implement, more well-informed interventional strategies to reduce readmissions.

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Section: Resultsmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Interventions aimed at addressing unplanned hospital readmissions in the U.S.: A systematic review

Ferdinand

Cheon

Bako

et al. 2018

JHA

Self Cite

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“…Fourth, previous evidence showed that pre-discharge patient/family education is a successful intervention to reduce preventable readmission [42,43]. Therefore, it would be important for hospital leaders or health care workers in children's hospitals to consider emphasizing the contents related to ambient air pollution when delivering education to the children with asthma and their family before discharge as one of the readmission reduction initiatives.…”

Section: Health Policy and Practice Implicationsmentioning

confidence: 99%

Effect of Ambient Air Pollution on Hospital Readmissions among the Pediatric Asthma Patient Population in South Texas: A Case-Crossover Study

Baek

Kash

et al. 2020

IJERPH

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Few studies have evaluated the association between ambient air pollution and hospital readmissions among children with asthma, especially in low-income communities. This study examined the short-term effects of ambient air pollutants on hospital readmissions for pediatric asthma in South Texas. A time-stratified case-crossover study was conducted using the hospitalization data from a children’s hospital and the air pollution data, including particulate matter 2.5 (PM2.5) and ozone concentrations, from the Centers for Disease Control and Prevention between 2010 and 2014. A conditional logistic regression analysis was performed to investigate the association between ambient air pollution and hospital readmissions, controlling for outdoor temperature. We identified 111 pediatric asthma patients readmitted to the hospital between 2010 and 2014. The single-pollutant models showed that PM2.5 concentration had a significant positive effect on risk for hospital readmissions (OR = 1.082, 95% CI = 1.008–1.162, p = 0.030). In the two-pollutant models, the increased risk of pediatric readmissions for asthma was significantly associated with both elevated ozone (OR = 1.023, 95% CI = 1.001–1.045, p = 0.042) and PM2.5 concentrations (OR = 1.080, 95% CI = 1.005–1.161, p = 0.036). The effects of ambient air pollutants on hospital readmissions varied by age and season. Our findings suggest that short-term (4 days) exposure to air pollutants might increase the risk of preventable hospital readmissions for pediatric asthma patients.

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“…Therefore, collaboration between clinical and community partners (e.g. PCPs, nonprofit organizations, and educators) for transitional care and followup would contribute to reducing repeated hospital admissions since appropriate care for asthma management in the community, such as asthma education, can prevent repeated hospitalizations (49)(50)(51).…”

Section: Implications For Healthcare Systemmentioning

confidence: 99%

Pediatric asthma hospitalization: individual and environmental characteristics of high utilizers in South Texas

Baek

Kash

et al. 2020

Journal of Asthma

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Objective: Few studies have examined factors affecting the high frequency of hospitalization for pediatric asthma. This study identifies individual and environmental characteristics of children with asthma from a low-income community with a high number of hospitalizations. Methods: The study population included 902 children admitted at least once to a children's hospital in South Texas because of asthma from 2010 to 2016. The population was divided into three groups by utilization frequency (high: !4 times, medium: 2-3 times, or low: 1 time). Individual-level factors at index admission and environmental factors were included for the analysis. Unadjusted and adjusted multivariate ordered logistic regression models were applied to identify significant characteristics of high hospital utilizers. Results: The high utilization group comprised 2.4% of total patients and accounted for substantial hospital resource utilization: 10.8% of all admissions and 13.5% of days stayed in the hospital. Patients in the high utilization group showed longer length of stay (LOS) and shorter time between admissions on average than the other two groups. The multivariate ordered logistic regression models revealed that age of 5-11 years (OR ¼ 0.57, 95%CI ¼ 0.35-0.93), longer LOS (2 days: OR ¼ 1.80, 95%CI ¼ 1.15-2.84; !3 days: OR ¼ 3.38, 95%CI ¼ 2.10-5.46), warm season at index admission (OR ¼ 1.49, 95%CI ¼ 1.01-2.20), and higher average ozone level in children's residential neighborhoods (OR ¼ 1.78, 95%CI ¼ 1.01-3.14) were significantly associated with a higher number of asthma hospitalizations. Conclusions: The findings suggest the importance of monitoring high hospital utilizers and establishing strategies for such patients based on their characteristics to reduce repeated hospitalizations and to increase optimal use of hospital resources.

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Successful hospital readmission reduction initiatives: Top five strategies to consider implementing today

Cited by 8 publications

References 15 publications

Interventions aimed at addressing unplanned hospital readmissions in the U.S.: A systematic review

Interventions aimed at addressing unplanned hospital readmissions in the U.S.: A systematic review

Effect of Ambient Air Pollution on Hospital Readmissions among the Pediatric Asthma Patient Population in South Texas: A Case-Crossover Study

Pediatric asthma hospitalization: individual and environmental characteristics of high utilizers in South Texas

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