‘Low-cost, clinic-based intervention’ curtails hospital readmission rates in lupus
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A multidisciplinary post-discharge intervention aimed at reducing 30-day hospital readmission rates among patients with systemic lupus erythematosus is feasible, but more data is needed to determine if it is effective, according to researchers.
“Systemic lupus erythematosus often requires inpatient hospitalization,” Elena Weinstein, MD, of the University of Colorado School of Medicine, told Healio Rheumatology. “About 20% to 25% of individuals with SLE are hospitalized each year.”
“SLE has one of the highest 30-day hospital readmission rates among chronic diseases in the United States, with 30-day readmission rates reported in the literature of 16.5-36%, the sixth highest 30-day readmission rate, higher than the readmission rate for other common chronic diseases such as congestive heart failure, chronic obstructive pulmonary disease and diabetes mellitus,” she added. “Not only are these readmissions linked to significant morbidity and mortality for patients, they also create a large economic burden on health care system, as they are often expensive admissions.”
To develop, and examine the feasibility of, a multidisciplinary post-discharge intervention that would reduce 30-day readmission rates in SLE, Weinstein and colleagues conducted a retrospective study of electronic health records at a university hospital. The study included patients with SLE who were admitted to the hospital for any reason during an 8-month period and compared those who were admitted prior to the intervention with those admitted afterward.
During the 8-month study period, 59 hospitalizations were included in the non-intervention group, while 73 hospitalizations received the multidisciplinary post-discharge intervention. This intervention included a template message sent to the rheumatology clinic nurses at the time of discharge, prompting them to call the patient to provide education and coordinate future visits. The primary outcome was the 30-day hospital readmission rate. The researchers used a multivariate mixed binomial regression model in their data analysis.
According to the researchers, the 30day readmission rate was 29% in the nonintervention group and 19% in the group that received the intervention. However, this difference was not statistically significant following multivariate analysis, they wrote.
“It is feasible to implement a simple and low-cost post-discharge intervention to reduce 30-day hospital readmission rates among patients with SLE,” Weinstein said. “While traditional discharge interventions focus on resources within the hospital, we utilized clinic-based resources to improve the inpatient to outpatient transition.”
She added: “By demonstrating that a low cost, clinic-based intervention can lower readmission rates in lupus patients, we show that all rheumatologists can be empowered to implement a simple intervention and help their lupus patients stay out of the hospital, thus improving their care and reducing economic burden of readmission for patients and health care systems.”
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