Adding to the growing body of evidence of the benefits of transitional care, a review of medical literature in the Annals of Internal Medicine found that some hospital-led interventions can improve outcomes for adult stroke and myocardial infarction patients.
Researchers looked at 44 studies and found that transitional care reduced length of stay for stroke patients, although they were less confident that it reduced mortality for myocardial infarction patients. Researchers also noted they couldn't conclude whether interventions such as patient and family education programs and community-based support affected outcomes, with insufficient evidence, they wrote. Nevertheless, few of the studies reported adverse events as a result of transitional care.
Inadequate care coordination, including poor care transitions, resulted in $25 billion to $45 billion in wasteful spending in 2011 through avoidable complications and unnecessary hospital readmissions, according to Health Affairs.
In addition to varied electronics systems across organizations and failure to notify other providers of discharge, there also is a lack of incentives to promote care transitions. In fact, critics of the current fee-for-service system suggest providers are gaming the system; for instance, some nursing homes unnecessarily transfer patients to hospitals to reap reimbursements, Health Affairs noted.
With the Institute of Medicine and the National Quality Forum setting care transitions as a national priority, the concept of continuity of care has made its way up to Capitol Hill.
Reps. Earl Blumenauer (D-Ore.), Thomas Petri (R-Wis.), Allyson Schwartz (D-Pa.) and Jan Schakowsky (D-Ill.) on Friday introduced the Medicare Transitional Care Act of 2012 to fund providers and beneficiaries with specific payments for coordination activities. Supported by the National Transitions of Care Coalition (NTOCC), the legislation aims to improve transitions from hospital to home, skilling nursing facility or another care setting for Medicare beneficiaries at risk for readmissions.
"The Affordable Care Act made significant progress in improving the coordination of care in our healthcare system, but still gaps remain to promoting the type of team-based, coordinated care that is critical to quality transitions of care," NTOCC Executive Director Cheri Lattimer said yesterday in a statement.
For more information:
- read the Annals of Internal Medicine study
- here's the Health Affairs policy brief
- read the NTOCC statement
- see Blumenauer's statement
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