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Small N.C. study backs having NPs visit patients before their discharge to cut readmissions

A very small pilot study done in North Carolina suggests that when   nurse practitioners visit Medicare patients in the hospital before discharge, readmission rates in the 30 days after discharge can be cut.

“It’s no longer the case that the primary-care provider takes care of the patient in the hospital,” investigator Katie Wingate, DNP, an adult-gerontological primary-care nurse practitioner at Kernersville Primary Care, in North Carolina, told Medscape.

“It’s strangers who do that now, and that’s terrifying. We’re sort of providing a familiar face for the patient. It’s pretty simple.”

Dr. Wingate has found that patients whose hospitalizations are not followed up by their primary-care provider are “10 times more likely to have a readmission.”

She tracked the 30-day outcomes of 10 elderly patients discharged from a local hospital who were part of a three-step care transition, which included a nurse practitioner visit during hospitalization.

“A lot of times, there’s a discharge coordinator, but that person isn’t typically the patient’s primary-care provider. That’s the most unique thing” about this intervention.

Dr. Wingate reported that none of the 10 study participants were readmitted to a hospital within 30 days of discharge.

To read more, please this link.


The economics of quality-improvement interventions to prevent readmissions

A study reported in JAMA Internal Medicine looked at whether quality-improvement interventions designed to reduce hospital readmissions are associated with net savings to the health system.

The findings:

“In this systematic review and data analysis of economic evaluations based on data for more than 16 700 patients, hospital readmissions declined by an average of 12.1% among populations with heart failure and 6.3% among general populations, but net savings to the health system were variable. In general populations, interventions that involved engaging patients and caregivers were associated with similar effectiveness but substantially larger net savings to the health system than other interventions.”

The authors concluded:

“Diverse interventions can be effective at reducing readmissions, but cost savings do not consistently occur. Interventions that engage patients and family members may be associated with larger net savings.”

To read the report, please hit this link.

Study casts doubt on readmission crackdown


Researchers and physicians at The Johns Hopkins Hospital, in Baltimore, are challenging the wildly accepted idea that readmissions are an accurate measure of quality. The Centers for Medicare & Medicaid services has put much emphasis on the need to reduce hospital readmissions.

In a study this month in Journal of Hospital Medicine, hospitalist Daniel J. Brotman, M.D., and his colleagues looked at nearly 4,500 acute-care hospitals’ hospital-wide readmission rates and compared them with those hospitals’ mortality rates in six areas used by the Centers for Medicare & Medicaid Services: heart attack, pneumonia, heart failure, stroke, chronic obstructive pulmonary disease, and coronary-artery bypass.

They found that hospitals with the highest  readmission  rates were more likely to show better mortality scores in patients treated for heart failure, COPD and stroke.

And adjusted odds ratios indicated that patients treated at hospitals with more readmitted patients had a fractionally better chance at survival than patients cared for at hospitals with lower readmission rates.

To read The Journal of Hospital Medicine report, please hit this link.

Study details fall in ER use in Oregon


Because of Oregon’s expansion of  Medicaid,  the rate of visits to emergency departments  as well as hospital readmissions have dropped despite  a more than 50 percent increase in the number of people using the program, according to a new analysis by the state.

Key findings of the report include:

  • 83.8 percent of Medicaid beneficiaries were able to receive appointments and care when they needed it, up slightly from 83 percent in 2014.
  • 43.1 enrollees visited an emergency department per 1,000 member months, compared with 47.3 in 2014.
  • 8.6 percent of adult Medicaid beneficiaries were readmitted to a hospital within 30 days of discharge, down from 11.4 percent.

The drop in ER use is especially surprising. In 2008, the state used a lottery to expand its Medicaid program for low-income adults and studies  showed an uptick in ER use.


To read the state report, please hit this link.

HealthLoop asserts platform cuts readmissions by 25%

Herewith a  look at HealthLoop’s patient-engagement platform.

It’s designed to automate follow-up care by helping physicians send customized patient- education information and reminders by email or text as patients recover from hospital visits. The company asserts that the platform lowers  hospital readmissions by 25 percent.

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