Outreach by telephone reduces hospital readmission risk, study finds

Cigna study examines gastrointestinal, respiratory, heart patients

BLOOMFIELD, Conn. — Reaching out to discharged hospital patients by telephone could help reduce the chances they'll be readmitted in the future, according to a new study by a healthcare service company.

Cigna announced results of the study of 3,988 patients with gastrointestinal, heart and lower respiratory diseases described as "high-risk" — defined as having an initial discharge major diagnosis of one of those diseases and a stay of three days or more — finding that prioritized, telephonic outreach by health plan case managers following discharge reduced readmission rates by 22%.

"Readmissions of high-risk patients make up a significant portion of healthcare expenses, accounting for 30% of total inpatient costs for private employer health plans," Cigna senior medical director Charles Foreman said. "The lesson learned from the Cigna study is that the timing and prioritizing of readmission intervention to high-risk patients is critical. Prioritizing telephone outreach to high-risk patients based on their discharge date and risk severity significantly reduces the likelihood of 60-day readmissions."

The company conducted a prospective, randomized control study of the effect of hospital discharge planning from health plan case managers on readmissions for high-risk patients. An intervention group of 1,994 patients received outreach and engagement within 24 hours of discharge, and their calls were made in descending risk order to engage the highest risk first. A control group, also with 1,994 patients, received delayed outreach and engagement 48 hours after discharge without call order by risk being applied.

The intent-to-treat, 60-day readmission rate for the treatment group was 7.4% versus 9.6% for the control group, representing a 22% relative reduction in all-cause readmissions.

"Healthcare organizations providing post-discharge telephonic outreach to patients with diagnoses related to heart, gastrointestinal and lower respiratory can use these findings to inform the alignment of their case management resources," Foreman said. "Further study needs to be done to test the prioritization intervention against all major diagnoses to confirm this approach impacts a wider profile of patients."

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