Mayo Clinic: Reduce readmissions with complex, patient-empowering interventions

Several strategies could potentially reduce 30-day hospital readmissions by nearly 20 percent, according to a Mayo Clinic review published in JAMA Internal Medicine.

"Reducing early hospital readmissions is a policy priority aimed at improving quality of care and lowering costs," lead author Aaron Leppin, M.D., told Mayo Clinic News Network. "Most importantly, we need to address this issue because hospital readmissions have a big impact on our patients' lives."

Leppin and his team reviewed 47 randomized studies on admission-reduction methods and found the most effective interventions--which reduce readmissions by nearly 40 percent--are more complex and focus on helping patients maintain their health. Despite this, providers increasingly used simpler, more technology-focused interventions, that are less effective, according to the review. When hospitals send patients home after taking care of their acute issues, Leppin said, they give patients lists of tasks to complete, which are often overwhelming. "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," Leppin said, according to the article.

"Effective approaches often are multifaceted and proactively seek to understand the complete patient context, often including in-person visits to the patient's home after discharge," Leppin told Mayo Clinic News Network. "This helps us assess the patients' living environment, their level of support, their resources, and their psychological and physical limitations."

Meanwhile, readmissions among congestive heart failure patients do not correlate with their socioeconomic status, according to a new report published in Circulation: Cardiovascular Quality and Outcomes. "There are too few variables in Medicare data to adequately capture a heart failure patient's social risks and therefore insufficient data available to researchers and policymakers to determine if current payment and reimbursement healthcare reform policies hurt hospitals that care for the more socially disadvantaged," lead author Alex Blum, M.D., of Icahn School of Medicine at Mount Sinai said in a statement.

To learn more:
- read the Mayo review
- here's the article
- here's the Circulation report (membership required)
- read the statement

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