Rebekah Gardner|Qijuan Li|Rosa Baier|Kristen Butterfield|Eric A. Coleman|Stefan Gravenstein
Is Implementation of the Care Transitions Intervention Associated with Cost Avoidance After Hospital Discharge?
Healthcentric Advisors|Providence College|Brown University|Providence College|Providence College|Healthcentric Advisors|Healthcentric Advisors|Providence College|University of Colorado Anschutz Medical Campus|Brown University|Providence College
poorlyexecuted transitions hospital contribute significant costs healthcare system several evidencebased interventions reduce postdischarge utilizationto evaluate cost avoidance associated implementation care transitions intervention ctia quasiexperimental cohort study using consecutive convenience samplingfeeforservice medicare beneficiaries hospitalized 1 january 2009 31 may 2011 six rhode island hospitalsthe cti patientcentered coaching intervention empower individuals better manage health begins inhospital continues 30 days including one home visit one two phone callswe examined postdischarge total utilization costs patients received coaching intervention group declined lost followup internal control group eligible approached external control group using propensity score matching control baseline differencescompared matched internal controls n 321 intervention group significantly lower utilization 6 months discharge lower mean total health care costs 14729 vs 18779 p 003 cost avoided per patient receiving intervention 3752 compared internal controls results external control group similar shifting costs utilization types observedthis analysis demonstrates cti generates meaningful cost avoidance least 6 months posthospitalization also provides useful metrics evaluate impact cost avoidance hospital readmission reduction programs