The Impact of a Transition of Care Program on Acute Myocardial Infarction Readmission Rates.
Jeffrey A MarbachDrew JohnsonJuergen KlooAmit ViraScott KeithWalter K KraftNatalie MargulesDavid WhellanPublished in: American journal of medical quality : the official journal of the American College of Medical Quality (2018)
Hospital discharge is a high-risk time period, and acute myocardial infarction (AMI) patients often have early readmissions. The authors hypothesized that a multifaceted AMI care coordination program would reduce early hospital readmission rates. The outcomes of patients receiving care coordination (n = 304) were compared to patients receiving standard care (n = 192). Multivariable analyses of the outcomes were conducted by conditional logistic regression of propensity score matched sets. The primary outcome-hospital readmission within 30 days of discharge-occurred in 18% of standard care patients and 11.8% of care coordination patients. Patients receiving care coordination demonstrated a 48% reduction in odds of readmission within 30 days (odds ratio = 0.52; P = .04; 95% CI = 0.28-0.97). These results are the first to demonstrate that inclusion in an AMI-specific care coordination program is associated with a significantly lower risk of 30-day hospital readmission.
Keyphrases
- healthcare
- acute myocardial infarction
- quality improvement
- palliative care
- end stage renal disease
- ejection fraction
- newly diagnosed
- affordable care act
- peritoneal dialysis
- pain management
- prognostic factors
- type diabetes
- percutaneous coronary intervention
- emergency department
- acute coronary syndrome
- adipose tissue
- coronary artery disease
- insulin resistance
- electronic health record