Discharge Transitional Care Failed To Significantly Rates of Hospital Readmission, Death: Study

Implementing specialized transitional care plans before discharge failed to reduce the rates of unplanned readmissions to the hospital or improve outcomes.

A new study suggests high-risk patients who underwent targeted intervention practices at discharge, which were intended to reduce the risk hospital readmission, did not fare better than patients who did not undergo specialized transitional care.

In a report published this month in the medical journal JAMA Internal Medicine, researchers from Switzerland evaluated the effectiveness of specialized intervention plans for patients who faced a higher risk for readmission based on various factors, including having high-risk conditions like heart problems, suffering complications during surgery or the hospital stay, or contracting an infection.

Researchers conducted a randomized study involving nearly 1,400 high risk patients across four teaching hospitals in Switzerland from 2018 to 2020, which was part of the TARGET–READ Randomized Clinical Trial.

Participants were placed in two groups, an intervention group and control group. The control group received the usual medical care from the hospital and a one page standard study information sheet.

The intervention group underwent targeted practices aimed at reducing hospital readmission. These included systematic medication control, a 15-minute patient education session with teach-back, a planned first follow-up visit with their primary care doctor, and post-discharge follow-up telephone calls from the study team at 3 and 14 days.

The findings indicated there was no difference in readmission rates or death risk between the two groups. Composite readmission rates and death rates in the intervention group were 21%, and readmission and death rates in the control group were 19%.

Researchers also noted there were no significant effects on post-discharge health care use, patient satisfaction with the quality of their care transition, or readmission costs.

When a patient is readmitted to the hospital after discharge, they can face a higher risk of death, infections, complications, and patient stress. Readmissions also increase costs to both the patient and the healthcare system. More so, roughly 30% of hospital readmissions are preventable, and 50% are potentially avoidable.

“Results of this study suggest that the difficulties in preventing hospital readmissions continue, even when using multimodal interventions targeting higher-risk patients,” wrote the study authors.

The findings of the study highlight the challenges hospitals face in trying to reduce hospital readmission rates and prevent negative patient outcomes, but more research is needed to determine the targeted approach that is the most effective on readmission rates, the researchers determined.