Case Management

Study: Putting focus on post-acute appointments can reduce readmissions

Case Management Insider, September 29, 2015

The American College of Cardiology’s “See You in 7,” can help to reduce heart-related readmissions, according to a study published in the September 1 issue of JACC: Heart Failure.

The study focused on 10 Michigan hospitals that were participating in the See You in 7 initiative, which calls on healthcare professionals to make sure that all heart failure and heart attack patients have a follow-up appointment scheduled with their doctor (or a cardiac rehabilitation referral), within seven days of their hospital discharge.

Each participating hospital chose to focus on at least one of the following metrics from the See You in 7 initiative:

  • Identifying heart failure patients prior to discharge
  • Scheduling and documenting a follow-up visit with a cardiology or primary care doctor within seven days of discharge
  • Providing patients with documentation of scheduled follow-up
  • Identifying and addressing barriers to keeping appointment
  • Ensuring patients arrive at scheduled follow up appointment
  • Making discharge summary available to follow-up healthcare providers

Researchers looked at the hospitals’ seven-day follow-up and 30-day readmission rates for these patients the year before they started the initiative and compared those numbers to their readmission rates after they started the program.

The result: A 2.6% decrease in 30-day readmission rates. This reduction came despite the fact that seven-day follow-up rates remained pretty low. Follow-up rates hovered between 31% and 34% at hospitals using the program, compared to 30% to 32% seven-day follow-up rates at non-participating hospitals.

In addition to reducing readmissions, the initiative also saved money. Per payment Medicare costs for inpatient days and 30-days post-discharge dropped by $182 at hospitals using the program.

“Our study clearly shows there are challenges in coordinating early follow-up care, since increases in seven-day post-discharge follow up were modest. However, despite this, hospitals in the program stepped up to address deficiencies in post-hospital care and reduce 30-day readmissions,” said senior author of the study Scott Hummel, MD, MS, an assistant professor of internal medicine at the University of Michigan Health System and cardiologist at the VA Ann Arbor Healthcare System in a written release.

Hospitals involved in the study also got a better understanding of why patients miss needed follow-up appointments by tracking visits and following up when patients skipped them, said study authors.

Click here to read the study.

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