Case Management

CMW mentor moment: Study finds discharge planning measures don?t reduce readmissions

Case Management Weekly, January 20, 2010

The following article is adapted from HCPro’s resource for hospital case managers—www.CaseManagementMentor.com—a free blog dedicated to connecting hospital case managers to industry pacesetters, peers, and best practices.

The New England Journal of Medicine (NEJM) reported last year that a study revealed one in five Medicare patients discharged from the hospital returned within 30 days. The estimated cost of unplanned hospital readmissions in 2004 was $17 billion of the $102 billion Medicare spent for hospitalizations.

However, a new study published in NEJM says improving publicly reported discharge planning measures will do little or nothing to reduce readmission.

Ashish K. Jha, MD, of Harvard School of Public Health and Brigham and Women's Hospital, and colleagues examined 2,222 hospital performances with respect to:

  • Whether charts adequately documented that patients with congestive heart failure received discharge instructions
  • Patient-reported experiences with discharge planning

Researchers used the September 2008 release of CMS’ Hospital Quality Alliance (HQA) database, which reports indicators that assess proper documentation of discharge planning in the medical records of patients with congestive heart failure. Researchers also used the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, which reports patients' perceptions of the adequacy of their discharge planning.

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