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September 12, 2013BMC GeriatricsOpen Access

Evaluation of a modified community based care transitions model to reduce costs and improve outcomes

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Why the study?

Does a modified community-based care transitions program reduce readmissions and costs?

Population

Patients participating in a modified community-based care transitions program

Design

Cohort

Follow-up

9 months

Key result

The modified community-based care transitions program reduced 30-day readmissions by 73% compared to the expected baseline rate (4% vs 15%).

Authors

MLMelanie D. LogueJDJennifer Drago

Discussion

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Overview

May inform geriatric discharge planning; leaves open randomized confirmation of cost savings and scalability.

Study Design

Type

Observational (n=149)

Multicenter

Yes

Structured PICO

Does a modified community-based care transitions program reduce readmissions and costs?

P
Population
149 Medicare fee-for-service beneficiaries aged 51 to 95 years discharged to home without skilled home care, followed for 30 days in a community-based care transitions program.
I
Intervention
Modified community-based care transitions program
O
Outcome
Readmissions and Medicare cost savings

Main Result

Effect estimate: 73% reduction

Absolute Event Rate: 4% vs 15%

A modified community-based care transitions program significantly reduced readmissions and generated Medicare cost savings over 9 months.

Limitations

  • No control group, preventing the establishment of causal links
  • Potential subject bias towards more stable patients as those receiving home care were excluded
  • Omissions in documentation due to the transition to a Web-based case management software
  • Small sample size

Cite This Study

Logue et al. (2013) conducted an observational in Medicare fee-for-service beneficiaries discharged to home (n=149). Modified community-based care transitions program vs. Historical baseline (expected readmission rate) was evaluated on 30-day readmission rate (73% reduction). The modified community-based care transitions program reduced 30-day readmissions by 73% compared to the expected baseline rate (4% vs 15%).

synapsesocial.com/papers/6a7c96cd0bb6134e42cf7e94https://doi.org/10.1186/1471-2318-13-94
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