Effect of Person-Centered Telehealth Service Implementation on 30-Day Readmissions and Hospital Reimbursement: A...

To evaluate the association between implementation of a personalized, postdischarge telehealth support program and 30-day hospital readmission among patients hospitalized with stroke.

This observational pre-post implementation study was conducted within an acute care hospital system and included adult patients (≥18 years) admitted with ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage. Following discharge, eligible patients were offered enrollment in a person-centered telehealth support program. The primary outcome was all-cause 30-day readmission. Multivariable regression models were used to adjust for baseline clinical characteristics.

Among 405 patients, 258 were admitted before telehealth implementation, 31 were enrolled in the telehealth program after implementation, and 116 were postimplementation nonenrollees. Thirty-day readmission occurred in 23 of 258 patients (8.9%) before implementation, in 0 of 31 telehealth enrollees (0%), and in 3 of 116 nonenrollees (2.6%). After adjustment for clinical covariates, postimplementation patients demonstrated a lower estimated risk of 30-day readmission compared with preimplementation patients, with the lowest risk observed among telehealth enrollees. Based on a 6.3% absolute reduction in readmissions and published cost estimates, telehealth implementation corresponded to an annual savings of approximately $112,000-$124,000 in avoided uncompensated care for uninsured patients and $545,000-$602,000 in reduced exposure to denied claims for insured patients per 1,000 strokes. Anticoagulant use was associated with a higher estimated probability of readmission.

Implementation of a person-centered postdischarge telehealth service was associated with substantially lower 30-day readmissions among patients hospitalized with stroke and may provide meaningful economic benefits by reducing costly readmissions and financial burden on hospitals.