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The care transitions intervention: translating from efficacy to effectiveness
Rachel Voss1, Rebekah Gardner, Rosa Baier
1Quality Partners of Rhode Island, Providence, RI 0290, USA.
Archives of Internal Medicine
|July 27, 2011
Summary
The Care Transitions Intervention reduced 30-day hospital readmissions by coaching fee-for-service Medicare patients. This study shows improved health outcomes are possible in real-world settings.
Area of Science:
- Health Services Research
- Public Health
- Health Policy
Background:
- Effective communication during hospital discharge improves patient outcomes and reduces healthcare costs.
- The Care Transitions Intervention (CTI) previously demonstrated a 30% reduction in 30-day hospital readmissions in a randomized controlled trial.
- Real-world validation of CTI in diverse healthcare settings is necessary.
Purpose of the Study:
- To test the hypothesis that CTI coaching would reduce 30-day readmission rates for fee-for-service Medicare beneficiaries.
- To evaluate CTI effectiveness in open, urban healthcare delivery systems.
Main Methods:
- A quasi-experimental prospective cohort study was conducted from January 2009 to June 2010.
- Coaches recruited fee-for-service Medicare patients across 6 Rhode Island hospitals for the CTI.
- Logistic regression analyzed 30-day readmission rates comparing the intervention group to internal and external control groups using claims and enrollment data.
Main Results:
- Participants receiving CTI coaching had a 30-day readmission rate of 12.8%, compared to 20.0% for those receiving no intervention (OR, 0.61; 95% CI, 0.42-0.88).
- Internal control group readmission rates (18.6%) were similar to external control group rates (18.6%).
Conclusions:
- The Care Transitions Intervention demonstrates effectiveness in a real-world implementation setting.
- The findings highlight the potential to enhance patient health outcomes through improved discharge processes in open healthcare environments.
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