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

被引:15
作者
Hamar, G. Brent [1 ]
Coberley, Carter [2 ]
Pope, James E. [1 ]
Cottrill, Andrew [3 ]
Verrall, Scott [3 ]
Larkin, Shaun [3 ]
Rula, Elizabeth Y. [4 ]
机构
[1] Healthways Inc, 701 Cool Springs Blvd, Franklin, TN 37067 USA
[2] 4080 Oxford Glen Dr, Franklin, TN 37067 USA
[3] Hosp Contribut Fund Australia HCF, Level 6,403 George St, Sydney, NSW 2000, Australia
[4] Tiv Hlth, 701 Cool Springs Blvd, Franklin, TN 37067 USA
关键词
OLDER MEDICAL PATIENTS; EMERGENCY-DEPARTMENT; INTENSIVE-CARE; QUALITY; TRANSITIONS; IMPROVEMENT; STRATEGIES; MORTALITY; PROGRAM; DISEASE;
D O I
10.1071/AH16059
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
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.
引用
收藏
页码:241 / 247
页数:7
相关论文
共 39 条
[1]  
AHMAC (Australian Health Ministers' Advisory Council), 2015, AB TORR STRAIT ISL G
[2]  
[Anonymous], 2011, COMP EFFECTIVENESS M
[3]   One third of hospital costs for atherothrombotic disease are attributable to readmissions: a linked data analysis [J].
Atkins, Emily R. ;
Geelhoed, Elizabeth A. ;
Knuiman, Matthew ;
Briffa, Tom G. .
BMC HEALTH SERVICES RESEARCH, 2014, 14
[4]  
Australasian College for Emergency Medicine, 2014, P02 AUSTR COLL EM ME
[5]  
Australasian College for Emergency Medicine, 2004, ACC BLOCK OV EM DEP
[6]  
Australian Institute of Health and Welfare, 2016, NAT HEALTHC AGR PI 1
[7]  
Australian Institute of Health and Welfare, 2017, NAT HEALTHC AGR 2015
[8]  
Australian Institute of Health and Welfare (AIHW), 2015, ADM PAT CAR 2013 201, V60
[9]   The Effect of Emergency Department Crowding on Clinically Oriented Outcomes [J].
Bernstein, Steven L. ;
Aronsky, Dominik ;
Duseja, Reena ;
Epstein, Stephen ;
Handel, Dan ;
Hwang, Ula ;
McCarthy, Melissa ;
McConnell, K. John ;
Pines, Jesse M. ;
Rathlev, Niels ;
Schafermeyer, Robert ;
Zwemer, Frank ;
Schull, Michael ;
Asplin, Brent R. .
ACADEMIC EMERGENCY MEDICINE, 2009, 16 (01) :1-10
[10]   cem: Coarsened exact matching in Stata [J].
Blackwell, Matthew ;
Iacus, Stefano ;
King, Gary ;
Porro, Giuseppe .
STATA JOURNAL, 2009, 9 (04) :524-546