title: Meta-Analysis of Clinical Trials That Evaluate the Effectiveness of Hospital-Initiated Postdischarge Interventions on Hospital Readmission.
abstract: Under pressure to avoid readmissions, hospitals are increasingly employing hospital-initiated postdischarge interventions (HiPDI), such as home visits and follow-up phone calls, to help patients after discharge. This study was conducted to assess the effectiveness of HiPDI on reducing hospital readmissions using a systematic review of clinical trials published between 1990 and 2014. We analyzed twenty articles on HiPDI (from 503 reviewed abstracts) containing 7,952 index hospitalizations followed for a median 3 months (range 1-24) after discharge for readmission. The two most common HiPDI included follow-up phone calls (n = 14, 70%) or home visits (n = 11, 55%); eighty-five percent (n = 17) of studies had multiple HiPDI. In meta-analysis, exposure to HiPDI was associated with a lower likelihood of readmission (odds ratio [OR], 0.8 [95% CI, 0.7-0.9]). Patients receiving ≥2 postdischarge home visits or ≥2 follow-up phone calls had the lowest likelihood of readmission (OR, 0.5 [95% CI, 0.4-0.8]). Hospital-initiated postdischarge interventions seem to have an effect on reducing hospital readmissions. Together, multiple home visits and follow-up phone calls may be the most effective HiPDI to reduce hospital readmission.
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Branowicki
authors.forename: Judith A
authors.initials: JA
authors.lastname: Vessey
authors.forename: Dionne A
authors.initials: DA
authors.lastname: Graham
authors.forename: Margaret A
authors.initials: MA
authors.lastname: McCabe
authors.forename: Alison L
authors.initials: AL
authors.lastname: Clapp
authors.forename: Kevin
authors.initials: K
authors.lastname: Blaine
authors.forename: Margaret R
authors.initials: MR
authors.lastname: OʼNeill
authors.forename: Julie A
authors.initials: JA
authors.lastname: Gouthro
authors.forename: Colleen K
authors.initials: CK
authors.lastname: Snydeman
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Kline
authors.forename: Vincent W
authors.initials: VW
authors.lastname: Chiang
authors.forename: Courtney
authors.initials: C
authors.lastname: Cannon
authors.forename: Jay G
authors.initials: JG
authors.lastname: Berry
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data*; D003266:Continuity of Patient Care / Q000458:organization & administration*; D061345:Early Medical Intervention / Q000379:methods*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006792:House Calls; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D017216:Telemedicine / Q000379:methods*