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Two studies highlight importance of transitional care in cardiac patients
Stauffer BD. Arch Intern Med. 2011;171:1238-1243.
Voss R. Arch Intern Med. 2011;171:1232-1237.
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Thirty-day readmission rates and health care costs were reduced by post-discharge intervention programs for patients with heart complications, according to results of two studies.
Communication between hospital providers, patients and receiving providers at the time of hospital discharge may yield better outcomes and reduced costs, according to findings from Voss and colleagues.
Their quasi-experimental cohort study was conducted from Jan. 1, 2009, to June 30, 2010, and involved six Rhode Island hospitals. A group of fee-for-service Medicare patients received a transition intervention.
The 30-day readmission rate among patients receiving the intervention was 12.8% compared with a 20% readmission rate among patients who did not receive the intervention (OR=0.61; 95% CI, 0.42-0.88). Those who declined to participate or who were lost to follow-up had an 18.6% readmission rate (OR=0.94; 95% CI, 0.77-1.14).
“The Care Transitions Intervention appears to be effective in this real-world implementation,” the researchers wrote. “This finding underscores the opportunity to improve health outcomes beginning at the time of discharge in open health care settings.”
Stauffer and colleagues conducted a study to determine the effect of nurse-led transitional care on readmission among patients with HF who were aged at least 65 years and were discharged from Baylor Medical Center Garland from Aug. 24, 2009, to April 30, 2010.
The intervention reduced 30-day readmission rates to Baylor Medical Center Garland by 48% during the post-intervention period, according to the results. This significant reduction was better than secular reductions seen at other participating facilities.
The intervention was also associated with an average reduction in the hospital contribution margin of $227 for each Medicare patient with HF.
“Preliminary results suggest that transitional care programs reduce 30-day readmission rates for patients with heart failure,” Stauffer and colleagues wrote. “This underscores the potential of the intervention to be effective in a real-world setting, but payment reform may be required for the intervention to be financially sustainable by hospitals.”
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