Hospital readmission efforts are successful, but don't always save money, according to a new Cedars-Sinai study published in JAMA Internal Medicine.
The researchers reviewed the effectiveness of financial benefit of quality improvement programs at U.S. medical centers in the U.S. and abroad.
The researchers found quality improvement interventions reduced readmissions by an average of 12.1% for heart failure patients and 6.3% for older adults with diverse health issues. However, they also found the average net savings for health systems were $972 per person for heart failure patients and a $169 average net loss per person for other patients.
The study authors conducted a review of data from 50 quality improvement studies that involved more than 16,700 patients. They said the costs varied so widely across studies that they could not “conclude definitely whether these interventions saved or lost money."
The interventions that produced the most net savings per patient involved engaged patients and caregivers. This included several cases that involved nurses or pharmacists who trained patients and family members about medication management, appropriate activities and potentially serious symptoms after discharge.
The results published in JAMA may surprise healthcare officials who view rehospitalization efforts as a way to contain costs. CMS penalizes hospitals for excessive readmissions, which Advisory Board said has led to nearly 2,600 hospitals losing more than $500 million in payments this year.
The lead researcher, Teryl Nuckols, MD, MSHS, was surprised that the interventions did not save money across the board.
“Hospitalization is very expensive, so avoiding even a few readmissions should have saved a lot of money,” Nuckols said. “Our findings suggest that there is no guarantee of net cost savings once the implementation costs associated with efforts to prevent readmissions are considered."