Completing a discharge-day Plan of Care Visit was associated with significantly lower odds of 30-day hospital readmission (OR 0.76; 95% CI 0.73-0.79).
Cohort (n=237,430)
Yes
Does the completion of Plan of Care Visits (POCV) reduce 30-day readmissions in adult hospitalized patients discharged to home?
Implementation of Plan of Care Visits involving the patient, nurse, and provider is associated with significantly lower odds of 30-day hospital readmission.
Effect estimate: OR 0.76 (95% CI 0.73-0.79)
BACKGROUND: Plan of Care of Visits (POCV), including the patient, nurse, and hospital provider were implemented across an integrated health system to improve provider-patient communication during hospitalization and patient outcomes. OBJECTIVES: To assess POCV adoption after implementation, patient characteristics assosites were classified as teachsites were classified as teachsites were classified as teachsites were classified as ciated with POCV completion, and association of POCV with 30-day readmissions. METHODS: This retrospective cohort study utilized electronic medical record (EMR) data of 237,430 adult patients discharged to home from 11 hospitals from January 2020 to December 2022. POCV completion was a discrete EMR variable. POCV adoption was estimated monthly by hospital as proportion of patients with at least 1 POCV during hospitalization, with variation among hospitals measured using the Variance Partition Coefficient (VPC). Multivariable logistic regressions assessed factors associated with POCV completion and POCV association with 30-day readmission. RESULTS: POCV adoption increased from 69% to 94% (2020-2022) and varied by 50% across hospitals (VPC 0.50, 95% CI: 0.29-0.70). Odds of a discharge-day POCV were lower among older patients (≥65 vs. 18-34 y, OR 0.81, CI: 0.79-0.83), and higher among female (OR 1.06; CI: 1.04-1.07), Asian (vs. White, OR 1.13; CI: 1.06-1.21), Hispanic (OR 1.09; CI: 1.05-1.13), and surgical patients (vs. medical, OR 1.33; CI: 1.30-1.35). Patients completing discharge-day POCV had lower 30-day readmission odds (2022 OR 0.76, CI: 0.73-0.79). Patients with POCV on ≥75% of hospital days had similar readmission odds trends. CONCLUSIONS: POCV implementation was successful, and POCV completion was associated with fewer 30-day readmissions. Future work should focus on increasing POCV adoption while reducing hospital variation.
Masiano et al. (Thu,) conducted a cohort in Hospitalization (n=237,430). Plan of Care Visits (POCV) vs. No discharge-day POCV was evaluated on 30-day readmission (OR 0.76, 95% CI 0.73-0.79). Completing a discharge-day Plan of Care Visit was associated with significantly lower odds of 30-day hospital readmission (OR 0.76; 95% CI 0.73-0.79).