Using Nurse Practitioner Co-Management to Reduce Hospitalizations and Readmissions Within a Home-Based Primary Care...

Area of Science:

• Healthcare Management
• Primary Care
• Geriatric Medicine

Background:

• Nurse practitioner (NP) co-management is a model where NPs and physicians share patient care responsibilities.
• Clinically complex and home-bound patients often require intensive management to prevent adverse health events.
• Home-based primary care programs serve vulnerable patient populations.

Purpose of the Study:

• To evaluate the impact of NP co-management on hospitalizations and 30-day readmissions for clinically complex patients in a home-based primary care program.
• To assess provider satisfaction with the NP co-management model.
• To explore potential cost savings associated with NP co-management.

Main Methods:

• A comparative study design was used, analyzing pre- and post-enrollment data for home-bound patients (n=87) in the Nurse Practitioner Co-Management Program.
• Data on hospitalizations and 30-day readmissions were collected from electronic medical records.
• Physician satisfaction was assessed via an anonymous online survey (n=13).

Main Results:

• Patients enrolled in NP co-management experienced significantly lower annual hospitalization rates (1.26 vs. 2.27, p = .005).
• A significant reduction in 30-day hospital readmissions was observed (5.8% vs. 17.2%, p = .004).
• A majority of physicians (8/13) reported reduced burnout after implementing NP co-management.

Conclusions:

• NP co-management is effective in reducing hospitalizations and readmissions for high-risk, home-bound patients.
• The model enhances provider satisfaction and may mitigate physician burnout.
• NP co-management offers potential benefits for patients, caregivers, providers, and healthcare institutions through improved outcomes and cost savings.