OBJECTIVE: To investigate the business case of postdischarge care transition (PDCT) among Medicare beneficiaries by conducting a cost-benefit analysis. DESIGN: Randomized controlled trial. SETTING: A general hospital in upstate New York State. PARTICIPANTS: Elderly Medicare beneficiaries being treated from October 2008 through December 2009 were randomly selected to receive services as part of a comprehensive PDCT program (intervention--173 patients) or regular discharge process (control--160 patients) and followed for 12 months. INTERVENTION: The intervention comprised five activities: development of a patient-centered health record, a structured discharge preparation checklist of critical activities, delivery of patient self-activation and management sessions, follow-up appointments, and coordination of data flow. MEASUREMENTS: Cost-benefit ratio of the PDCT program; self-management skills and abilities. RESULTS: The 1-year readmission analysis revealed that control participants were more likely to be readmitted than intervention participants (58.2% vs 48.2%; P = .08); with most of that difference observed in the 91 to 365 days after discharge. Findings from the cost-benefit analysis revealed a cost-benefit ratio of 1.09, which indicates that, for every $1 spent on the program, a saving of $1.09 was realized. In addition, participating in a care transition program significantly enhanced self-management skills and abilities. CONCLUSION: Postdischarge care transition programs have a dual benefit of enhancing elderly adults' self-management skills and abilities and producing cost savings. This study builds a case for the inclusion of PDCT programs as a reimbursable service in benefit packages.
RCT Entities:
OBJECTIVE: To investigate the business case of postdischarge care transition (PDCT) among Medicare beneficiaries by conducting a cost-benefit analysis. DESIGN: Randomized controlled trial. SETTING: A general hospital in upstate New York State. PARTICIPANTS: Elderly Medicare beneficiaries being treated from October 2008 through December 2009 were randomly selected to receive services as part of a comprehensive PDCT program (intervention--173 patients) or regular discharge process (control--160 patients) and followed for 12 months. INTERVENTION: The intervention comprised five activities: development of a patient-centered health record, a structured discharge preparation checklist of critical activities, delivery of patient self-activation and management sessions, follow-up appointments, and coordination of data flow. MEASUREMENTS: Cost-benefit ratio of the PDCT program; self-management skills and abilities. RESULTS: The 1-year readmission analysis revealed that control participants were more likely to be readmitted than intervention participants (58.2% vs 48.2%; P = .08); with most of that difference observed in the 91 to 365 days after discharge. Findings from the cost-benefit analysis revealed a cost-benefit ratio of 1.09, which indicates that, for every $1 spent on the program, a saving of $1.09 was realized. In addition, participating in a care transition program significantly enhanced self-management skills and abilities. CONCLUSION: Postdischarge care transition programs have a dual benefit of enhancing elderly adults' self-management skills and abilities and producing cost savings. This study builds a case for the inclusion of PDCT programs as a reimbursable service in benefit packages.
Authors: Mohanad Odeh; Claire Scullin; Glenda Fleming; Michael G Scott; Robert Horne; James C McElnay Journal: Br J Clin Pharmacol Date: 2019-01-24 Impact factor: 4.335
Authors: Sara C Keller; Danielle Ciuffetelli; Warren Bilker; Anne Norris; Daniel Timko; Alex Rosen; Jennifer S Myers; Janet Hines; Joshua Metlay Journal: J Pharm Technol Date: 2013-10
Authors: Rebekah Gardner; Qijuan Li; Rosa R Baier; Kristen Butterfield; Eric A Coleman; Stefan Gravenstein Journal: J Gen Intern Med Date: 2014-03-04 Impact factor: 5.128
Authors: Daniela C Gonçalves-Bradley; Natasha A Lannin; Lindy M Clemson; Ian D Cameron; Sasha Shepperd Journal: Cochrane Database Syst Rev Date: 2016-01-27