Economic Evaluation of Quality Improvement Interventions Designed to Prevent Hospital Readmission

Importance: Quality improvement (QI) interventions can reduce hospital readmission, but little is known about their economic value. Objective: To systematically review economic evaluations of QI interventions designed to reduce readmissions. Data Sources: Databases searched included PubMed, Econlit, the Centre for Reviews P <. 001; based on 22 studies with complete data) and by 6. 3% among general populations (95% CI, 4. 0%-8. 7%; P <. 001; 18 studies). The mean net savings to the health system per patient was 972 among patients with HF (95% CI, -642 to 2586; P =. 23; 24 studies), and the mean net loss was 169 among general populations (95% CI, -2610 to 2949; P =. 90; 21 studies), reflecting nonsignificant differences. Among general populations, interventions that engaged patients and caregivers were associated with greater net savings (1714 vs -6568; P =. 006). Conclusions and Relevance: Multicomponent QI interventions can be effective at reducing readmissions relative to the status quo, but net costs vary. Interventions that engage general populations of patients and their caregivers may offer greater value to the health system, but the implications for patients and caregivers are unknown.