Home-based nurse practitioners demonstrate reductions in rehospitalizations and emergency department visits in a clinically complex patient population through an academic-clinical partnership

Background and purpose: The purpose of this pilot study was to describe the impact of one aspect of an academic-clinical partnership that showed how assigning nurse practitioner faculty to deliver home-based primary care services to clinically complex patients would decrease rehospitalizations and emergency department visit rates. Methods: Rehospitalizations and emergency department visits of a cohort of 82 patients were recorded from April 15, 2016 to August 25, 2016 and compared with the same cohort during the two pre-home care inception periods (6 months and 1 year) using insurance claims-based data. Conclusions: Compared with the 1-year pre-home care inception period, there was a decrease of 23.7% in emergency department visits and 34.9% decrease in rehospitalizations after the implementation of the home-based primary care program and a decrease of 35.6% in emergency department visits and 59.4% decrease in rehospitalizations compared with 6 months of pre-home care inception. Implications for practice: Allowing nurse practitioners with full practice authority to deliver home-based primary health care services to homebound, chronically ill, recently discharged, and/or disabled patients can decrease costs and promote optimum health care in this population. In addition, these programs provide valuable learning experiences for nurse practitioner students and their preceptors.