Mayo Meta-Analysis Finds Multi-faceted Strategies Best for Readmissions
A Mayo Clinic review of 47 studies found that 30-day readmissions can be reduced by almost 20 percent when specific efforts are taken to prevent them. Key among these are interventions to help patients deal with the work passed on to them at discharge.
Patients are sent home from hospitals because we have addressed their acute issues, said the review's first author, Aaron Leppin, M.D. They go home with a list of tasks that include what they were doing prior to the hospitalization and new self-care tasks prescribed on discharge. Some patients cannot handle all these requests, and it is not uncommon for them to be readmitted soon after they get home. Sometimes these readmissions can be prevented.
After reviewing 47 randomized studies assessing methods to reduce readmissions, researchers identified that the most effective interventions those that reduce readmissions by almost 40 percent are more complex and are designed to help patients deal with the work of being a patient. These interventions were also found to save money for payers.
Effective approaches often are multifaceted and proactively seek to understand the complete patient context, often including in-person visits to the patients home after discharge, Leppin said. This helps us assess the patients living environment, their level of support, their resources, and their psychological and physical limitations.
The study also found that, over the past 20 years, there has been a tendency to get away from this approach and try simpler, more "high-tech" strategies; these have generally been less effective.