Meta-Analysis of Clinical Trials That Evaluate the Effectiveness of Hospital-Initiated Postdischarge Interventions on Hospital Readmission

• Published in: Journal for healthcare quality Vol. 39; no. 6; p. 354
• Main Authors: Branowicki, Patricia M, Vessey, Judith A, Graham, Dionne A, McCabe, Margaret A, Clapp, Alison L, Blaine, Kevin, OʼNeill, Margaret R, Gouthro, Julie A, Snydeman, Colleen K, Kline, Nancy E, Chiang, Vincent W, Cannon, Courtney, Berry, Jay G
• Format: Journal Article
• Language: English
• Published: United States 01.11.2017
• Subjects: Adult; Aged; Aged, 80 and over; Clinical Trials as Topic - statistics & numerical data; Continuity of Patient Care - organization & administration; Early Medical Intervention - methods; Female; Hospitalization - statistics & numerical data; House Calls; Humans; Male; Middle Aged; Patient Discharge - statistics & numerical data; Patient Readmission - statistics & numerical data; Telemedicine - methods
• ISSN: 1945-1474
• DOI: 10.1097/JHQ.0000000000000057

Under pressure to avoid readmissions, hospitals are increasingly employing hospital-initiated postdischarge interventions (HiPDI), such as home visits and follow-up phone calls, to help patients after discharge. This study was conducted to assess the effectiveness of HiPDI on reducing hospital readmissions using a systematic review of clinical trials published between 1990 and 2014. We analyzed twenty articles on HiPDI (from 503 reviewed abstracts) containing 7,952 index hospitalizations followed for a median 3 months (range 1-24) after discharge for readmission. The two most common HiPDI included follow-up phone calls (n = 14, 70%) or home visits (n = 11, 55%); eighty-five percent (n = 17) of studies had multiple HiPDI. In meta-analysis, exposure to HiPDI was associated with a lower likelihood of readmission (odds ratio [OR], 0.8 [95% CI, 0.7-0.9]). Patients receiving ≥2 postdischarge home visits or ≥2 follow-up phone calls had the lowest likelihood of readmission (OR, 0.5 [95% CI, 0.4-0.8]). Hospital-initiated postdischarge interventions seem to have an effect on reducing hospital readmissions. Together, multiple home visits and follow-up phone calls may be the most effective HiPDI to reduce hospital readmission.