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Am J Manag Care. 2010 Oct;16(10):778-83.

Hospital readmission among participants in a transitional case management program.

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OptumHealth, a division of United Health Group, Tampa, FL 33634, USA.



To examine the relationship between participation in a large wellness and care management company's transitional case management (TCM) program and hospital readmission.


Retrospective cohort study.


A total of 10,258 members were identified as either participants or nonparticipants in TCM from data archives of a large healthcare company. Engagement and claims data were analyzed using multivariable logistic regression. Readmission predictors that were studied included TCM engagement, the major diagnostic categories of "musculoskeletal" and "digestive," length of stay for the initial hospitalization, cost of initial inpatient stay, risk score, age, and sex.


Readmission rates were lower among individuals who were engaged in TCM compared with those who were not engaged. Within 30 days, 12.66% of individuals participating in TCM were readmitted to the hospital compared with 35.85% of those not participating (P <.0001). In the first 30 days, individuals who did not participate in TCM were almost 4 times more likely to have a hospital readmission than those who did participate. The most important predictor of hospital readmission was engagement in TCM. Individuals who were engaged in the program were less likely to be readmitted than those not engaged in the program (P <.0001).


Implementation of a telephonic TCM program was associated with lower rates of readmission within 30 days. Timely engagement in TCM was associated with a lower likelihood of readmission.

[Indexed for MEDLINE]
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