Preventing Hospital Readmissions: Evaluation of a Transitional Care Management Program

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)

Andrea Moody (Creator)

Institution

The University of North Carolina at Greensboro (UNCG )

Web Site: http://library.uncg.edu/

Advisor

Julia Kordsmeier

Abstract: Background: In 2012, the Centers for Medicaid and Medicare Services (CMS) introduced the Hospital Readmissions Reduction Program (HRRP). HRRP encouraged hospitals to improve rates of unplanned readmissions by reducing CMS payments to institutions that exceeded predetermined readmission rates for certain conditions. In 2018, a 457-bed suburban hospital in the southeastern United States launched a transitional care (TC) program to provide outpatient support during the first 30 days after hospital discharge and prevent unplanned hospital readmissions. Purpose: A summative evaluation of processes at a TC program was completed to identify the impact of the program on unplanned 30-day hospital readmissions. Methods: Questionnaires were completed by inpatient and outpatient program staff members to obtain details describing methods for referring patients to the program and interventions used to curtail unplanned readmissions. Electronic medical records of 608 patients discharged after hospitalization for sepsis, pneumonia, or chronic obstructive pulmonary disease in 2017, 2019, and 2020 were manually reviewed to compare readmission rates for program participants and non-participants. Results: Analysis of readmission rates were mixed. In 2019, readmission rates for both participants in the program (15.79%) and non-participants (16.25%) improved, with a statistically significant reduction for those in the transitional care program. In 2020, readmission rates for participants in the program increased (25%), though rates for non-participants continued to decline (13.79%). Conclusions: This TC program was comparable in structure to successful programs described in the literature. However, like the existing literature, impact of the program on readmissions was mixed.

Preventing Hospital Readmissions: Evaluation of a Transitional Care Management Program
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Created on 2/1/2023
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Additional Information

Publication

Dissertation

Language: English

Date: 2022

Keywords

transitional care, hospital readmission

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