Proactive chronic care management can reduce hospital admission, readmission rates

Two Healthways Center for Health Research studies recently published in Population Health Management demonstrate that hospital admissions and readmissions can be reduced through chronic care management and proactive interventions, such as telephonic outreach, resulting in considerable cost savings.

The first study, "The Impact of Postdischarge Telephonic Follow-up on Hospital Readmissions," is based on claims data from more than 30,000 members of a commercial health plan that were discharged from a hospital in 2008. Upon discharge, patients often do not receive the necessary education and follow-up to prevent otherwise avoidable readmissions. The study reveals the impact that communication with a patient over the telephone after discharge can have on reducing preventable hospital readmissions and minimizing costs.

Patients who received follow-up phone calls within 14 days of discharge were 23 percent less likely to be readmitted to the hospital. Patients who do not receive a follow-up call within 14 days of discharge are 1.3 times more likely to be readmitted to the hospital within 30 days of being discharged.

"While previous studies have demonstrated a reduction in readmissions based on the capacity of hospitals and clinics to provide supplemental discharge counseling, this study demonstrates that the same effect can be achieved through efficiently scaled and delivered telephonic interventions," said James E. Pope, M.D., Chief Science Officer, Healthways. "These findings clearly indicate that timely discharge follow-up by telephone to supplement standard care is effective at reducing near-term hospital readmissions, thus providing a means of reducing costs for health plans and their members."

The second study, "The Impact of a Proactive Chronic Care Management Program on Hospital Admission Rates in a German Health Insurance Society," was conducted among a group of 23,000 health insurance members in Germany and confirms that proactive telephonic chronic care management calls can help reduce hospital admissions among patients with chronic disease. Overall, the admission rate in the intervention group decreased by 6.2 percent, compared with a 14.9 percent increase in admissions among the comparison group.

"The increasing prevalence of chronic disease is an international epidemic that has dramatic consequences for both individual quality of life and the economies of entire countries," said Matt Kelliher, President, Healthways International. "The results of this study demonstrate the worldwide effectiveness of proactive chronic care management programs in helping individuals better manage their chronic conditions and avoid hospital admissions."

"The Impact of Postdischarge Telephonic Follow-up on Hospital Readmissions" is available online at: www.liebertonline.com/doi/full/10.1089/pop.2009.0076 while "The Impact of a Proactive Chronic Care Management Program on Hospital Admission Rates in a German Health Insurance Society" is available at: www.liebertonline.com/doi/full/10.1089/pop.2010.0032.

Source: Healthways