An outpatient critical care transition clinic model reduces admissions/readmissions in medically complex patients.
Am J Manag Care
; 27(9): e301-e307, 2021 09 01.
Article
in En
| MEDLINE
| ID: mdl-34533912
ABSTRACT
OBJECTIVES:
Reducing hospital admissions in patients with multiple complex chronic conditions is both a quality indicator and cost-effective to health care systems. This study assesses and compares utilization rates and cost of encounters between patients referred and seen in an outpatient critical care transition clinic (Healthy Transitions Clinic [HTC]) and those referred and not seen. STUDYDESIGN:
Retrospective cohorts.METHODS:
Patients with complex chronic conditions discharged from a tertiary/quaternary acute care hospital or emergency department (March 1, 2015, to February 29, 2016) were referred to an outpatient critical care transition clinic. Comparative cohorts were those patients who attended this transition clinic and those who did not. Pre- and post-HTC referral visits, with health care utilization evaluations including admissions/readmissions, attention to social determinants of health, and cost assessments, were compared among the cohorts.RESULTS:
Insurance coverage differed significantly in its distribution between the groups (χ2 = 22.99; P < .001); therefore, an adjusted relative risk model was used. Inpatient admissions significantly increased, by 31%, in the non-HTC cohort (P = .03); a significant increase in the rate of 30-day readmissions (69%) occurred in the HTC group (P < .001) at 6 months post index admission. Length of stay did not differ pre- and post HTC visit. Although not statistically significant, visits to the HTC reduced median all-cost and HTC cohort cost by more than $1 million.CONCLUSIONS:
In patients with complex chronic medical conditions with recent hospital admissions, the HTC model appears to reduce both admissions and encounter costs. Further community/regional studies are needed to better define this observation on a longitudinal basis.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Patient Readmission
/
Patient Transfer
Type of study:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Aspects:
Determinantes_sociais_saude
/
Equity_inequality
Limits:
Humans
Language:
En
Journal:
Am J Manag Care
Journal subject:
SERVICOS DE SAUDE
Year:
2021
Document type:
Article