Key result
The THRIVE clinical pathway reduced 30-day readmissions (14.3% vs 28.8%, p=0.05) and emergency department visits compared to standard care in Medicaid-insured individuals.
Why the study?
Chronically ill Medicaid-insured adults face health inequities after hospitalisation, including higher 30-day readmissions and postacute ED visits with inconsistently addressed social needs.
Does the THRIVE clinical pathway reduce 30-day readmissions and emergency department visits in chronically ill Medicaid-insured adults transitioning from hospital to home?
Cohort (n=479)
No
Does the THRIVE clinical pathway reduce 30-day readmissions and emergency department visits in chronically ill Medicaid-insured adults transitioning from hospital to home?
Absolute Event Rate: 14.3% vs 28.8%
p-value: p=0.05
A multidisciplinary transitional care pathway tailored for Medicaid-insured patients can effectively reduce 30-day hospital readmissions and emergency department visits.
May support tailored transitional care for Medicaid patients; hypothesis-generating and requires RCTs before practice change.
BACKGROUND: Chronically ill adults insured by Medicaid experience health inequities following hospitalisation. LOCAL PROBLEM: Postacute outcomes, including rates of 30-day readmissions and postacute emergency department (ED), were higher among Medicaid-insured individuals compared with commercially insured individuals and social needs were inconsistently addressed. METHODS: An interdisciplinary team introduced a clinical pathway called 'THRIVE' to provide postacute wrap-around services for individuals insured by Medicaid. INTERVENTION: Enrolment into the THRIVE clinical pathway occurred during hospitalisation and multidisciplinary services were deployed into homes within 48 hours of discharge to address clinical and social needs. RESULTS: Compared with those not enrolled in THRIVE (n=437), individuals who participated in the THRIVE clinical pathway (n=42) experienced fewer readmissions (14.3% vs 28.4%) and ED visits (14.3% vs 28.8 %). CONCLUSION: THRIVE is a promising clinical pathway that increases access to ambulatory care after discharge and may reduce readmissions and ED visits.
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Carthon et al. (2022) conducted a cohort in Multiple chronic conditions in Medicaid-insured adults (n=479). THRIVE clinical pathway vs. Standard care (not enrolled in THRIVE) was evaluated on 30-day readmissions (p=0.05). The THRIVE clinical pathway reduced 30-day readmissions (14.3% vs 28.8%, p=0.05) and emergency department visits compared to standard care in Medicaid-insured individuals.
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