The effect of a collaborative pharmacist-hospital care transition program on the likelihood of 30-day readmission.

Am J Health Syst Pharm

Heather S. Kirkham, Ph.D., M.P.H., is Manager, Clinical Outcomes and Analytics; and Bobby L. Clark, Ph.D., M.H.A., M.A., M.S.Pharm., M.S., is Senior Director, Clinical Outcomes and Analytics, Walgreen Company, Deerfield, IL. Jacquelyn Paynter, M.P.H., B.S.N., RN, CCM, is Director of Case Management, Rockdale Medical Center, Conyers, GA; at the time of writing she was Executive Director, Care Management, DeKalb Medical, Decatur, GA. Geraint H. Lewis, FRCP, FFPH, is Chief Data Officer, Patients and Information, National Health Service England, Leeds, United Kingdom. Ian Duncan, FSA MAAA, is Vice President, Clinical Outcomes and Analytics, Walgreen Company.

Published: May 2014

Purpose: The effect of a collaborative pharmacist-hospital care transition program on the likelihood of 30-day readmission was evaluated.

Methods: This retrospective cohort study was conducted in two acute care hospitals within the same hospital system in the southeastern United States. One hospital initiated a care transition program in January 2011; the other hospital did not have such a program. All patients who were discharged from either hospital to home from January 1, 2010, through December 31, 2011, were included in the study. The two key program components included bedside delivery of postdischarge medications and follow-up telephone calls two to three days after discharge. The likelihood of readmission was assessed using multiple logistic regression.

Results: Over the 2-year study period, 19,659 unique patients had 26,781 qualifying index admissions, 2,523 of which resulted in a readmission within 30 days of discharge. After adjusting for various demographic and clinical characteristics, the usual care group (i.e., patients who did not participate in the program) had nearly twice the odds of readmission within 30 days (odds ratio [OR], 1.90; 95% confidence interval [CI], 1.35-2.67), compared with the intervention group (i.e., program participants). For patients age 65 years or older, those in the usual care group had a sixfold increase in the odds of a 30-day readmission (OR, 6.05; 95% CI, 1.92-19.00) relative to those in the intervention group.

Conclusion: A care transition program was associated with a lower likelihood of readmission and had a greater effect on older patients.

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Source
http://dx.doi.org/10.2146/ajhp130457DOI Listing

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