April 11, 2014
Hospital readmissions are a serious problem that affect thousands of patients nationwide and cost the U.S. health-care system an estimated $17.4 billion a year. More than 2,000 hospitals across the country are expected to face penalties this year for high readmission rates.
Against this backdrop, a study in one UNC Hospitals clinic led by Assistant Professor Jamie Cavanaugh, PharmD, found that a new follow-up program for patients that have recently been discharged from the hospital reduced readmission rates within thirty days by 65 percent.
In addition, the study, published online April 1 by the Journal of General Internal Medicine, found that one hospital readmission within thirty days is prevented for every seven patients seen in the hospital follow-up program.
“Patients don’t want to come back to the hospital, and we don’t want them to if we can prevent it,” says Cavanaugh, an assistant professor in the UNC Eshelman School of Pharmacy and the UNC School of Medicine.
“At UNC we’ve shown that pharmacists, physicians, and social workers working together can cut readmissions by almost two-thirds. That saves time, saves money, and saves the patient and their family from another hospital stay,” she says.
The study evaluated a new program created by the Internal Medicine Clinic at UNC Hospitals for patients that have recently been discharged from the hospital. The program includes identification of patients that have been discharged, a process for contacting patients after hospital discharge, and standardization of the hospital follow-up appointment content. The hospital follow-up appointments are with a clinical pharmacist practitioner and a physician.
The program was evaluated by comparing readmission rates of UNC Internal Medicine Clinic patients seen in the hospital follow-up clinic to those that did not receive the enhanced services. Patients in both groups were discharged from the hospital in the same month and were selected at random. The study evaluated hospital readmission at thirty and ninety days, as well as emergency-department use.
Coauthors of the study are Christine D. Jones, MD, MS; Genevieve Embree, MD; Katy Tsai, MD; Thomas Miller, MD; Betsy Bryant Shilliday, PharmD; Brooke McGuirt, MBA; Robin Roche, MSW; Michael Pignone, MD, MPH; Darren A. DeWalt, MD, MPH; and Shana Ratner, MD.
All of the authors are from the UNC School of Medicine or the UNC Eshelman School of Pharmacy except for Jones, who is from the University of Colorado, Denver.
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