An Intensive Intervention to Reduce Readmissions for Frequently Hospitalized Patients: the CHAMP Randomized...

Area of Science:

• Health Services Research
• Clinical Interventions
• Patient Outcomes

Background:

• A small group of patients account for a disproportionate number of hospital readmissions.
• The Complex High Admission Management Program (CHAMP) was developed to enhance care continuity and decrease readmissions for high-utilization patients.

Purpose of the Study:

• To compare hospital utilization metrics between patients in the CHAMP program and those receiving usual care.

Main Methods:

• A pragmatic randomized controlled trial was conducted.
• Inclusion criteria targeted patients with frequent 30-day inpatient readmissions or a combination of inpatient, observation, and referral admissions.
• Patients were randomized to either CHAMP, managed by an interdisciplinary team with comprehensive care planning, or usual care.

Main Results:

• The study included 75 patients in CHAMP and 76 in the control group, with similar baseline characteristics.
• At 180 days post-enrollment, CHAMP patients had a higher incidence of 30-day inpatient readmissions (1.3) compared to the control group (0.8) (p=0.04).
• No significant differences were observed in secondary outcomes, including total hospital admissions, hospital days, emergency department visits, or outpatient clinic visits.

Conclusions:

• While frequently hospitalized patients generally showed reduced utilization over time, the CHAMP intervention was associated with increased readmissions compared to usual care.
• This increase may be attributed to care consolidation within a single hospital.
• Further research is needed to identify specific patient subgroups who might benefit from tailored, persistent interventions to manage high utilization.