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Multidisciplinary intervention reducing readmissions in medical inpatients: a prospective, non-randomized study

Torisson, Gustav LU ; Minthon, Lennart LU ; Stavenow, Lars and Londos, Elisabet LU (2013) In Clinical Interventions in Aging 8. p.1295-1304
Abstract
Background: The purpose of this study was to examine whether a multidisciplinary intervention targeting drug-related problems, cognitive impairment, and discharge miscommunication could reduce readmissions in a general hospital population. Methods: This prospective, non-randomized intervention study was carried out at the department of general internal medicine at a tertiary university hospital. Two hundred medical inpatients living in the community and aged over 60 years were included. Ninety-nine patients received interventions and 101 received standard care. Control/intervention allocation was determined by geographic selection. Interventions consisted of a comprehensive medication review, improved discharge planning, post-discharge... (More)
Background: The purpose of this study was to examine whether a multidisciplinary intervention targeting drug-related problems, cognitive impairment, and discharge miscommunication could reduce readmissions in a general hospital population. Methods: This prospective, non-randomized intervention study was carried out at the department of general internal medicine at a tertiary university hospital. Two hundred medical inpatients living in the community and aged over 60 years were included. Ninety-nine patients received interventions and 101 received standard care. Control/intervention allocation was determined by geographic selection. Interventions consisted of a comprehensive medication review, improved discharge planning, post-discharge telephone follow-up, and liaison with the patient's general practitioner. The main outcome measures recorded were readmissions and hospital nights 12 months after discharge. Separate analyses were made for 12-month survivors and from an intention-to-treat perspective. Comparative analyses were made between groups as well as within groups over time. Results: After 12 months, survivors in the control group had 125 readmissions in total, compared with 58 in the intervention group (Mann-Whitney U test, P = 0.02). For hospital nights, the numbers were 1,228 and 492, respectively (P = 0.009). Yearly admissions had increased from the previous year in the control group from 77 to 125 (Wilcoxon signed-rank test, P = 0.002) and decreased from 75 to 58 in the intervention group (P = 0.25). From the intention-to-treat perspective, the same general pattern was observed but was not significant (1,827 versus 1,008 hospital nights, Mann-Whitney test, P = 0.054). Conclusion: A multidisciplinary approach, targeting several different areas, could substantially lower readmissions and hospital costs in a non-terminal general hospital population. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
medical inpatients, hospital readmissions, intervention, drug-related, problems, cognitive impairment, hospital discharge
in
Clinical Interventions in Aging
volume
8
pages
1295 - 1304
publisher
Dove Medical Press Ltd.
external identifiers
  • wos:000324792500001
  • pmid:24106422
  • scopus:84884677848
ISSN
1178-1998
DOI
10.2147/CIA.S49133
language
English
LU publication?
yes
id
e9eb263c-ebfd-4b48-9c5f-ba5810754528 (old id 4102035)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/24106422?dopt=Abstract
date added to LUP
2013-11-07 14:22:16
date last changed
2019-03-12 01:11:21
@article{e9eb263c-ebfd-4b48-9c5f-ba5810754528,
  abstract     = {Background: The purpose of this study was to examine whether a multidisciplinary intervention targeting drug-related problems, cognitive impairment, and discharge miscommunication could reduce readmissions in a general hospital population. Methods: This prospective, non-randomized intervention study was carried out at the department of general internal medicine at a tertiary university hospital. Two hundred medical inpatients living in the community and aged over 60 years were included. Ninety-nine patients received interventions and 101 received standard care. Control/intervention allocation was determined by geographic selection. Interventions consisted of a comprehensive medication review, improved discharge planning, post-discharge telephone follow-up, and liaison with the patient's general practitioner. The main outcome measures recorded were readmissions and hospital nights 12 months after discharge. Separate analyses were made for 12-month survivors and from an intention-to-treat perspective. Comparative analyses were made between groups as well as within groups over time. Results: After 12 months, survivors in the control group had 125 readmissions in total, compared with 58 in the intervention group (Mann-Whitney U test, P = 0.02). For hospital nights, the numbers were 1,228 and 492, respectively (P = 0.009). Yearly admissions had increased from the previous year in the control group from 77 to 125 (Wilcoxon signed-rank test, P = 0.002) and decreased from 75 to 58 in the intervention group (P = 0.25). From the intention-to-treat perspective, the same general pattern was observed but was not significant (1,827 versus 1,008 hospital nights, Mann-Whitney test, P = 0.054). Conclusion: A multidisciplinary approach, targeting several different areas, could substantially lower readmissions and hospital costs in a non-terminal general hospital population.},
  author       = {Torisson, Gustav and Minthon, Lennart and Stavenow, Lars and Londos, Elisabet},
  issn         = {1178-1998},
  keyword      = {medical inpatients,hospital readmissions,intervention,drug-related,problems,cognitive impairment,hospital discharge},
  language     = {eng},
  pages        = {1295--1304},
  publisher    = {Dove Medical Press Ltd.},
  series       = {Clinical Interventions in Aging},
  title        = {Multidisciplinary intervention reducing readmissions in medical inpatients: a prospective, non-randomized study},
  url          = {http://dx.doi.org/10.2147/CIA.S49133},
  volume       = {8},
  year         = {2013},
}