Annotated Bibliography on Hospital Readmissions - Paper Example

Kocher, R. P., & Adashi, E. Y. (2011). Hospital readmissions and the Affordable Care Act: paying for coordinated quality care. Jama, 306(16), 1794-1795

The authors acknowledge the critical need and increasing scrutiny of the hospital readmission in different settings. In this article, they point out some of the negative implications of increased hospital readmission rates, especially within the first thirty days of discharge. Some of the highlighted effects include increased patient risks, overstretching of hospital facilities and lowering patients confidence in the quality of care. The authors use the case of the United States Patient Protection and Affordable Care Act (ACA) as one of the mechanisms feasibly used to reduce the incidences of readmissions.

Despite focussing on specific medical cases including acute myocardial infarction, heart failure, and pneumonia, the authors point to a similar trend in other conditions as well. It points out that policy approaches provide the most practical way of ensuring a sustainable hospital readmission. It cites the payment incentives to avoid readmissions adopted by the US Department of Health and Human Services as one of the ways of reducing readmission cases. Based on this example, the authors point that reducing readmission in different healthcare setting requires radical and sustainable initiatives. It also elucidates the role of multifaceted approach in reducing readmission, especially for critical illnesses. The article succinctly expresses the collective role that agencies and policies such as the Centres for Medicare & Medicaid Services, the United States Patient Protection and Affordable Care Act and Department of Health and Human Services in an efficient reduction of admission rates.

Bodenheimer, T., Wagner, E. H., & Grumbach, K. (2002). Improving Primary Care for Patients with Chronic Illness: The Chronic Care Model, Part 2. Jama, 288(15), 1909-1914.

The authors of the article premise their research on an appreciation of the fact that the nature of primary care provided to patients critically determine their likelihood of readmission thus need for its resolution. The article focuses on effectiveness of chronic care model in improving management of conditions. It uses information drawn from proximate studies that expressly show the extent of achievement of the medication design. Despite the fact that the rates of admission vary depending on patients health condition, the study focuses on diabetes as an example. It also evaluates some of the social and economic implications of an effective chronic care model among the patients such as reducing medical costs and alleviating repeated adverse health episodes.

In its assessment of the past studies conducted on the topic, the authors assert that most of them indicate a positive outcome from the implementation of chronic care model. Therefore, the authors express the importance of targeted healthcare standards in improving the process or outcome of medical interventions to reduce the possibility of readmissions. In essence, the article advances the notion that models such as the chronic care model in reducing healthcare expenses and decongesting the hospital facilities from repeat admissions are effective. Despite the fact that the authors support the fact that the models can profoundly reduce repeated admissions, it is important to eliminate first the potential hindrances for their increased adoption.

Bodenheimer, T., Wagner, E. H., & Grumbach, K. (2002). Improving Primary Care for Patients with Chronic Illness. Jama, 288(14), 1775-1779.

The article focuses on strategies adopted under the US Affordable Care Act (ACA) to compel medical facilities that receive payment for a diagnosis-related group (DRG) to reduce excessive readmissions. Therefore, it provides insights into the use of corporate coercion in the form of imposing financial penalties on hospitals that record extreme incidences of increased readmissions. Nonetheless, the authors contend that the mechanism only provides a weak mechanism for overcoming the strong counter-incentives inherent in diagnosis-related group based payments.

The article also exposes some of the failures of the financial penalties on hospitals in reducing readmission of patients such as the fact that it fails to reward the medical facilities that improve. Based on these limitations, the authors provide an alternative mechanism called a warranty payment, which serves as an incentive for hospitals to get with the readmission reduction programs. It points that the Centres for Medicare & Medicaid Services readmissions-penalty policy is a feasible approach to resolving readmission in hospitals but factors such as economic slumps, advances in ambulatory care, and increased pressure on reimbursement rates impede its success.

Boutwell, A. E., Johnson, M. B., Rutherford, P., Watson, S. R., Vecchioni, N., Auerbach, B. S., ... & Wagner, C. (2011). An early look at a four-state initiative to reduce avoidable hospital readmissions. Health Affairs, 30(7), 1272-1280.

The article focuses on the effects of 2009 State Action on Avoidable Rehospitalisation initiative (STAAR). The authors use the three state-based action carried out in Michigan, Ohio, and Washington as a mechanism that brings together the statelevel leadership in bolstering mechanisms directed at reducing rehospitalisation. It points to the political and leadership goodwill in developing and sustaining interventions for hospital readmissions. It provides a discourse on how partnerships between health facilities including sharing patient health data and collaborative interventions in minimizing the risk of recurrence of diseases among already discharged patients.

The authors argue that despite the lack of publicly available data on the achievements of STAAR, it point to its effectiveness in aligning various complementary medical interventions at the state level, in developing the state-wide rehospitalisation data reports, and mobilizing the hospitals to embrace mechanisms that reduce rehospitalisation. Therefore, the article asserts the significance of partnerships between hospitals in sharing pertinent medical information about the patients such as records of their previous treatments and diagnosis as means of ensuing effective treatments that reduce the likelihood of readmissions. It also underscores the significance of routine review of readmission cases; establish possible causes and deigning evidence-based interventions.

References

Bodenheimer, T., Wagner, E. H., & Grumbach, K. (2002). Improving primary care for patients with chronic illness: the chronic care model, Part 2. Jama, 288(15), 1909-1914.

Bodenheimer, T., Wagner, E. H., & Grumbach, K. (2002). Improving primary care for patients with chronic illness. Jama, 288(14), 1775-1779.

Boutwell, A. E., Johnson, M. B., Rutherford, P., Watson, S. R., Vecchioni, N., Auerbach, B. S., ... & Wagner, C. (2011). An early look at a four-state initiative to reduce avoidable hospital readmissions. Health Affairs, 30(7), 1272-1280.

Kocher, R. P., & Adashi, E. Y. (2011). Hospital readmissions and the Affordable Care Act: paying for coordinated quality care. Jama, 306(16), 1794-1795