Effect of post-hospital discharge telephonic intervention on hospital readmissions in a privately insured population in Australia
G. Brent Hamar A E , Carter Coberley B , James E. Pope A , Andrew Cottrill C , Scott Verrall C , Shaun Larkin C and Elizabeth Y. Rula D
+ Author Affiliations
- Author Affiliations
A Healthways Inc., 701 Cool Springs Boulevard, Franklin, TN 37067, USA.
B 4080 Oxford Glen Drive, Franklin, TN 37067, USA. Email: carter@coberley.com
C Hospitals Contribution Fund of Australia (HCF), Level 6, 403 George Street, Sydney, NSW 2000, Australia. Email: acottrill@hcf.com.au; sverrall@hcf.com.au; slarkin@hcf.com.au
D Tivity Health, 701 Cool Springs Boulevard, Franklin, TN 37067, USA. Email: elizabeth.rula@tivityhealth.com
E Corresponding author. Email: brent.hamar@healthways.com
Australian Health Review 42(3) 241-247 https://doi.org/10.1071/AH16059
Submitted: 3 March 2016 Accepted: 2 February 2017 Published: 10 April 2017
Journal compilation © AHHA 2018 Open Access CC BY-NC-ND
Abstract
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).
Methods 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.
Conclusions The HODI program post-discharge telephonic support to patients recently discharged from a hospital effectively reduced the incidence and odds of hospital 28-day readmission in a diseased population.
What is known about the topic? High readmission rates are a recognised problem in Australia and contribute to the over 600 000 potentially preventable hospitalisations per year.
What does this paper add? 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%.
What are the implications for practitioners? The significant and sizable effect of the intervention support the delivery of telephonic support after hospital discharge as a scalable approach to reduce readmissions.
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