Ongoing Efforts to Reduce Readmission Rates

The following are highlights of abstracts that focus on readmission rates, an increasingly important subject for hospitals that are subject to evolving rules and regulations as they relate to reimbursement.

Ashraf et al presented data from their study, The Utilization of Trained Volunteers to Decrease Hospital Readmission in Patients With Heart Failure. The authors note that patients with congestive heart failure (CHF) have a high 30-day hospital readmission rate often due to both dietary and pharmacological non-compliance. The goal of this study was to determine if trained volunteers could be used to increase patients’ compliance with the treatment of CHF, subsequently reducing their 30-day readmission rate. The research team randomly assigned 137 patients who were hospitalized with acute exacerbation of CHF to either an interventional arm or control arm. The interventional arm patients received “dietary and pharmacologic education by a trained volunteer, and a phone call within 48 hours of discharge.” The 30-day readmission rate in the interventional arm was 7% compared to 19% in the control arm with a relative risk reduction of 63% and an absolute risk reduction of 12%, leading the authors to conclude that “the use of trained volunteer staff to educate patients hospitalized with congestive heart failure about their disease and to reinforce both pharmacologic and non-pharmacologic compliance can improve both 30-day re-hospitalization and morbidity.”

Kasaju et al released the findings from their study, Can the SOAR Scoring System Predict Mortality and Hospital Readmission in Moderate and High Risk Community Acquired Pneumonia? A Prospective Validation Study. The objective of the study was “to determine the validity and accuracy of the systolic blood pressure (BP), oxygenation, age, and respiratory rate (SOAR) scoring system in predicting 30-day all cause mortality and hospital readmission in moderate- to high-risk CAP.” After evaluating 119 admitted adult patients with moderate to severe CAP using the SOAR index, the researchers concluded that “SOAR is a simple and rapid tool of prognosticating moderate- to high-risk community acquired pneumonia.”

Wirtz and Allen presented data from their study, Reduced 30-Day Readmission Rate With Implementation of a COPD Transitional Care Clinic at an Urban Community Hospital. The purpose of the study was to evaluate what degree participation in a COPD transitional care clinic (CTCC) impacts 30-day readmission rates. The research team evaluated the number of Ohio State University Hospital East (OSUHE) patients that were discharged with a primary discharge diagnosis of COPD exacerbation. These patients were eligible to be scheduled an appointment in the CTCC within 1 week of discharge, and CTCC visits were conducted by an advanced practice nurse (APN). The researchers concluded that “further analysis is necessary to determine if the transitional clinic initiative decreased the hospital-wide readmission rate for patients with COPD exacerbation,” and added that “due to the high no-show rate, future endeavors will be directed at providing transitional care via teleconferencing and in-home visits.”

To read more about research highlights at CHEST 2012, please visit the American College of Chest Physicians website.