کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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6219085 | 1607432 | 2016 | 7 صفحه PDF | دانلود رایگان |
ObjectiveTo assess the association between the length of consistent primary care as part of an accountable care organization (attribution length) and population-level and same-hospital readmissions. Readmission studies are generally focused on same-hospital readmissions rather than readmissions to any hospital (population-level readmissions).Study designA retrospective study of Medicaid claims data for 28â794 unique pediatric patients attributed to a single children's hospital between September 2013 and May 2015. Study used logistic regression to estimate the impact of attribution length on readmissions and a zero-inflated Poisson model to assess the impact of attribution length on readmission cost and readmission days.ResultsThe study showed attribution length was associated with a significant reduction in the population-level 30-day readmission rate from 8.9%-6.2% (PÂ =Â .010) primarily by reducing readmissions that occurred at hospitals other than the discharging hospital. There was no significant reduction in the same-hospital readmission rate. Readmissions to a different hospital occurred in 37% of readmissions. Although not significant at the PÂ =Â .05 level, attribution length was associated with a 44% reduction (PÂ =Â .100) in 30-day readmission costs or a 5.0% reduction in the cost of an inpatient episode of care and a 53% reduction (PÂ =Â .019) in readmission days.ConclusionsConsistent primary care (attribution length) may be able to reduce 30-day, pediatric Medicaid patients' readmissions at the population level. The decrease occurred primarily in readmissions to hospitals other than the discharging hospital. There was no decrease in the rate of same-hospital readmissions.
Journal: The Journal of Pediatrics - Volume 170, March 2016, Pages 113-119