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

• Published in: American journal of health-system pharmacy 2014-05, Vol.71 (9), p.739-745
• Main Authors: KIRKHAM, HEATHER S, CLARK, BOBBY L, PAYNTER, JACQUELYN, LEWIS, GERAINT H, DUNCAN, IAN
• Format: Article
• Language: English
• Subjects: Aged; Analysis; Biological and medical sciences; Cooperative Behavior; Female; Health care industry; Humans; Likelihood Functions; Male; Medical care, Cost of; Medical sciences; Odds Ratio; Patient Readmission; Pharmacists; Pharmacy Service, Hospital; Practice; Prevention and actions; Professional Role; Public health. Hygiene; Public health. Hygiene-occupational medicine; Regression Analysis; Retrospective Studies; Risk Factors; Services; Specific populations (family, woman, child, elderly...)
• ISSN: 1079-2082; 1535-2900
• DOI: 10.2146/ajhp130457

PURPOSEThe effect of a collaborative pharmacist–hospital care transition program on the likelihood of 30-day readmission was evaluated. METHODSThis 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. RESULTSOver 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. CONCLUSIONA care transition program was associated with a lower likelihood of readmission and had a greater effect on older patients.