Association between clinic physician workforce and avoidable readmission: a retrospective database research.

Area of Science:

• Health Services Research
• Public Health Policy
• Healthcare Management

Background:

• Reducing hospitalization costs necessitates preventing avoidable hospitalizations and readmissions.
• Ambulatory care sensitive conditions (ACSCs) represent a significant burden on healthcare systems due to potential for preventable hospitalizations.

Purpose of the Study:

• To investigate the association between the density of clinic-based physicians and unplanned readmissions for ACSCs.
• To inform healthcare policy regarding resource allocation for readmission prevention.

Main Methods:

• Retrospective analysis of a nationwide administrative claims database in Japan.
• Inclusion of patients aged 65 years and older admitted with ACSCs from home and discharged home (n=127,209).
• Hierarchical logistic regression modeling to assess the impact of clinic physician workforce on 30-day and 90-day ACSC-related readmissions.

Main Results:

• The 30-day and 90-day ACSC-related readmission rates were 3.7% and 4.6%, respectively.
• Higher numbers of full-time equivalent (FTE) clinic physicians per capita were significantly associated with lower odds of 30-day and 90-day readmissions for ACSCs.
• The observed association remained consistent across sensitivity analyses.

Conclusions:

• A robust clinic physician workforce is a key factor in preventing readmissions for ACSCs among patients with a history of such admissions.
• Regional healthcare strategies aimed at reducing avoidable readmissions should prioritize policies that bolster the clinic physician workforce.