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 Post-Infection Readmissions Easily Prevented With Outpatient Help, JAMA Study Finds

Nearly half of patients readmitted to hospitals after being treated for severe infections came back with conditions that could have been treated by outpatient services, a new study has found.
 
Researchers looked at some 2,617 seniors who had been treated for sepsis, a potentially fatal blood infection. More than 40 percent of them were back in the hospital within three months, and more than 40 percent of those patients came back with conditions that could have been treated or prevented outside the hospital, the team says.
 
The results were published in the latest issue of the Journal of the American Medical Association. Indirectly, it buttresses providers’ claim that their version of short-stay, acute care can keep seniors out of hospitals and save the public health system millions, or even billions.
 
The high prevalence and concentration of specific diagnoses during the early post-discharge period suggest that further study is warranted of the feasibility and potential benefit of post-discharge interventions tailored to patients' personalized risk for a limited number of common conditions,” lead author Hallie Prescott, MD, at the University of Michigan Ann Arbor, writes for the team.
 
Indeed, the 10 most common readmission diagnoses were for conditions that Prescott and colleagues call “ambulatory care sensitive conditions,” or problems that can be treated by outpatient caretakers. The leading diagnoses were congestive heart failure, pneumonia, chronic obstructive pulmonary disease problems, and urinary tract infections.
 
Overall, infections—including sepsis, pneumonia, urinary tract, and skin or soft tissue infections—accounted for 12 percent of readmission diagnoses, Prescott and company find.
 
Last fall, researchers at Navigant Healthcare, a consulting firm, argued that the move to bundled payment models offered a plum opportunity to high-quality providers. Under the emerging payment models, post-acute care providers can integrate their services into health networks and become one of the focal points on the continuum of care, Navigant said.
 
Bill Myers is Provider’s senior editor. Email him at wmyers@providermagazine.com; follow him on Twitter, @ProviderMyers.
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