title: Hospitalization event notifications and reductions in readmissions of Medicare fee-for-service beneficiaries in the Bronx, New York.
abstract: OBJECTIVE
  Follow-up with a primary care provider after hospital discharge has been associated with a reduced likelihood of readmission. However, primary care providers are frequently unaware of their patients' hospitalizations. Event notification may be an effective tool for reducing readmissions by notifying primary care providers when their patients have been admitted to and discharged from a hospital.
  
  
  METHODS
  We examined the effect of an event notification system on 30-day readmissions in the Bronx, New York. The Bronx has among the highest readmission rates in the country and is a particularly challenging setting to improve care due to the low socioeconomic status of the county and high rates of poor health behaviors among its residents. The study cohort included 2559 Medicare fee-for-service beneficiaries associated with 14 141 hospital admissions over the period January 2010 through June 2014. Linear regression models with beneficiary-level fixed-effects were used to estimate the impact of event notifications on readmissions by comparing the likelihood of rehospitalization for a beneficiary before and after event notifications were active.
  
  
  RESULTS
  The unadjusted 30-day readmission rate when event notifications were not active was 29.5% compared to 26.5% when alerts were active. Regression estimates indicated that active hospitalization alert services were associated with a 2.9 percentage point reduction in the likelihood of readmission (95% confidence interval: -5.5, -0.4).
  
  
  CONCLUSIONS
  Alerting providers through event notifications may be an effective tool for improving the quality and efficiency of care among high-risk populations.
authors.affiliation: Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, 10065, USA.
authors.forename: Mark Aaron
authors.initials: MA
authors.lastname: Unruh
authors.affiliation: Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, 10065, USA.
authors.forename: Hye-Young
authors.initials: HY
authors.lastname: Jung
authors.affiliation: Department of Healthcare Policy and Research, Department of Medicine, Department of Pediatrics, Weill Cornell Medical College, New York, NY, 10065, USA.
authors.forename: Rainu
authors.initials: R
authors.lastname: Kaushal
authors.affiliation: Department of Healthcare Policy & Management, Indiana University Richard M. Fairbanks School of Public Health - Indianapolis, Affiliated Scientist, Regenstrief Institute, Inc., Indianapolis, IN, USA.
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Vest
mesh_terms: D000359:Aftercare; D018588:Fee-for-Service Plans; D066275:Health Information Exchange; D006760:Hospitalization; D006801:Humans; D006278:Medicare; D009519:New York City; D010359:Patient Readmission / Q000706:statistics & numerical data; D014481:United States
keywords: Medicare; health information exchange; readmissions