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What curbs readmissions? Apparently, not much

November 2011

Published in the November 2011 issue of Today’s Hospitalist

What curbs readmissions? Apparently, not much

A REVIEW OF STUDIES that tested readmission prevention strategies has found that there isn’t any clear evidence that such strategies actually reduce readmissions. Researchers noted, however, that those results may have more to do with the limitations of the studies reviewed, many of which were single-site trials.

Researchers from Northwestern University identified more than 40 studies that looked at three different types of interventions: pre-discharge, which included medication reconciliation and the scheduling of follow-up appointments; post-discharge, which included follow-up phone calls and home visits; and bridging interventions, which included the use of transitional coaches. No single intervention alone, the researchers wrote, was found to reduce 30-day readmission rates.

The authors noted that Medicare’s plan to penalize hospitals for preventable readmissions might be premature if evidence does not solidly back the effectiveness of interventions to reduce readmission rates.
The study was published in the Oct. 18 Annals of Internal Medicine.

How’s comanagement working for you?

SURVEYS COMPLETED BY MEMBERS of a hepatology comanagement service at one academic center found that while hospitalists wanted to be informed about every decision in patient care, hepatologists did not feel they needed that level of detail.

In addition to that finding, 40% of hospitalists said in follow-up surveys that they would have liked to have more influence in directing overall management. (None of the hepatologists claimed in the surveys that they needed more influence.) Those results indicate some tension in leadership expectations between the two groups of physicians, according to the researchers.

The study, which was published in the September Journal of Hospital Medicine, was conducted by researchers at the University of Chicago. While strong majorities of hospitalists and hepatologists surveyed felt that comanagement improved patient care, that view was shared by only 40% of nurse practitioners who worked with the hospitalists and 50% of hepatology fellows.

Most of the clinicians surveyed in the service, however, agreed that they preferred when patient management was being coordinated by a single physician leader.