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Popul Health Manag. 2018 Oct;21(5):395-400. doi: 10.1089/pop.2017.0167. Epub 2018 Feb 13.

Impact of Comprehensive Medication Management on Hospital Readmission Rates.

Author information

1
1 Health Outcomes, Fairview Pharmacy Services, Minneapolis, Minnesota.
2
2 Medication Therapy Management, Fairview Pharmacy Services, Minneapolis, Minnesota.
3
3 Population Health Analytics, Fairview Health Services, St. Paul, Minnesota.

Abstract

In 2012, the Fairview Health System implemented a formal care transitions process that included referrals to outpatient services provided by medication therapy management (MTM) pharmacists, among other clinical services. This analysis evaluates the impact of the MTM-provided comprehensive medication management (CMM) service on readmission rates. Retrospective electronic medical record (EMR) data were used to identify hospital admissions between December 1, 2012, and July 31, 2015. Thirty- and 60-day readmission rates were calculated in both a CMM and comparator cohort. Readmission rates also were stratified by readmission risk category. A total of 43,711 patients, contributing 57,673 hospitalizations, were included in the analysis. Of those, 1291 hospitalizations had a CMM visit within 30 days of discharge (median 6 days) and were considered the CMM cohort. Patients who received a CMM visit had a significantly lower rate of 30-day readmissions (8.6% vs. 12.8%, P < 0.001). The 60-day readmission rate remained lower among CMM patients but did not reach statistical significance (15.6% vs. 17.6%; P = 0.0528). When patients in each cohort were stratified by readmission risk category, the CMM cohort had a statistically significant lower rate of 30-day readmission in the highest risk groups (Average: 7.1% vs. 9.5%, P = 0.025; Elevated: 9.9% vs. 21.4%, P < 0.001; High: 18.3% vs. 35.9%, P < 0.001; Extreme: 36.4% vs. 77.7%, P = 0.006). CMM performed by an MTM pharmacist reduces the rate of readmission at 30 days post discharge and may have the largest impact among patients at highest risk of readmission.

KEYWORDS:

drug use; evidence-based care; population health; quality measures; risk stratification

PMID:
29437537
DOI:
10.1089/pop.2017.0167
[Indexed for MEDLINE]

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