Mayo Clinic Study: Hospital Readmission Rate Not Affected by Follow-Up Appt's

Here is some discouraging news for those who thought making sure patients have their follow appointments after being discharged from the hospital would lower their chances of readmission and therefore save money:

Improving follow-up appointments is often considered one of the key strategies for reducing costly hospital readmissions, but a new study suggests that better discharge processes don't reduce 30-day readmission rates at all.

While previous research has found that follow-up appointments reduce readmissions for special patient populations, the latest study, which was conducted by Mayo Clinic researchers and appears in the latest Archives of Internal Medicine, examined nearly 5,000 dismissal summaries for general medicine patients discharged in 2006 from Mayo Clinic hospitals in Rochester, MN. While most (60%) patients were discharged with instructions for follow-up appointments, there was no difference in hospital readmission rates, emergency department visits, or mortality rates 30 days after the discharge.

At 180 days, those who had a follow-up appointment were actually more likely to be readmitted or have an adverse event than those who hadn't.

The results suggest that hospitals and physicians still have work to do in determining how to reduce hospital readmissions and even "call into question the concept of using readmissions as a quality indicator for the original hospitalization" because most readmissions were unrelated to the original admission, the authors said in their report.

Reducing re-hospitalization has been a major goal of CMS and the Obama administration, as well as many specialty societies, payers, and state agencies. Just this week, the New Jersey Hospital Association announced a statewide effort to reduce readmissions related to heart failure and CIGNA Corp. contracted with an East Hartford, CT, home health business to tackle the issue.

Readmissions are a big target in the healthcare industry in part because they represent what many consider to be an unnecessary driver of spiraling costs. Return visits to hospitals cost the government nearly $17 billion every year, according to a 2009 report.

Focusing on follow-up visits for patients with multiple comorbidities or longer hospital stays may be more effective than a blanket approach to follow-up care, according to the report. However, the researchers caution that more research is needed and acknowledge that the study was limited in scope and did not look into factors such as compliance with follow-up instruction.

Reducing costs in health care continues to be difficult or not as easy as it seems.