Impact of a national campaign on hospital readmissions in home care patients

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Abstract

Objective

Assess impact of nationwide home health quality improvement campaign to reduce acute care hospitalization of home health recipients.

Design

Observational pre–post comparison of self-selected participating and non-participating agencies' quality performance; survey to determine uptake of program materials.

Setting

US home health care agencies.

Participants

A total of 147 agencies with 147 non-participating agencies matched on patient length of service, pre-intervention hospitalization rate and pre-intervention rate of change in hospitalization rate.

Intervention(s)

Public events; provision of educational packages and technical assistance; quality measure feedback.

Main outcome measure(s)

Post-intervention difference in risk-adjusted acute care hospitalization rate between participants and non-participants; difference in self-reported campaign material use between agencies whose hospitalization rate declined 2% or more and those whose rates increased by 2% or more.

Results

Hospitalization rate had a negative trend beginning before the campaign. In the matched pairs studied, it did not differ significantly between participants and non-participants, or from pre- to post-intervention period (28% in every case). Agencies that improved were more likely to report activities consistent with the campaign and using campaign interventions than those not improving (P < 0.001), regardless of participation status.

Conclusions

Merely agreeing to participate in the campaign did not improve performance, but effective participation through adoption of campaign methods did.

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