Authors: James E. Pope, Andrew Cottrill, Scott Verrall, Shaun Larkin, Elizabeth Y. Rula, G. Brent Hamar and Carter Coberley Australian Health Review, 2017
Objective: The aim of the present study was to evaluate the effect of telephone support after hospital discharge to reduce early hospital readmission among members of the disease management program My Health Guardian (MHG) offered by the Hospitals Contribution Fund of Australia (HCF).
Method: A quasi-experimental retrospective design compared 28-day readmissions of patients with chronic disease between two groups: (1) a treatment group, consisting of MHG program members who participated in a hospital discharge (HODI) call; and (2) a comparison group of non-participating MHG members. Study groups were matched for age, gender, length of stay, index admission diagnoses and prior MHG program exposure. Adjusted incidence rate ratios (IRR) and odds ratios (OR) were estimated using zero-inflated negative binomial and logistic regression models respectively.
Results: The treatment group exhibited a 29% lower incidence of 28-day readmissions than the comparison group (adjusted IRR 0.71; 95% confidence interval (CI) 0.59–0.86). The odds of treatment group members being readmitted at least once within 28 days of discharge were 25% lower than the odds for comparison members (adjusted OR 0.75; 95% CI 0.63–0.89). Reduction in readmission incidence was estimated to avoid A$713 730 in cost.
Conclusion: The HODI program post-discharge telephonic support to patients recently dis- charged from a hospital effectively reduced the incidence and odds of hospital 28-day readmission in a diseased population.
- High readmission rates are a recognized problem in Australia and contribute to the over 600 000 potentially preventable hospitalizations per year.
- The present study is the first study of a scalable intervention delivered to an Australian population with a wide variety of conditions for the purpose of reducing readmissions. The intervention reduced 28-day readmission incidence by 29%.
- The significant and sizable effect of the intervention support the delivery of telephonic support after hospital discharge as a scalable approach to reduce readmissions.