Date of Award

1-1-2017

Embargo Period

1-1-2019

Document Type

Dissertation

Degree Name

Doctor of Health Administration

College

College of Health Professions

First Advisor

Annie Simpson

Second Advisor

Christina Daley

Third Advisor

Jonathan Ringo

Fourth Advisor

James S Zoller

Abstract

Nationally, COPD readmission rates are 22.6% while CHF readmission rates are 24.7%, both major contributors in making the need to reduce readmissions a national priority. Our aim was to assess whether a post-discharge call program staffed with experienced overseas nurses who used a call center management system to track calls and responses could reduce 30-day readmissions. We conducted a retrospective cohort review comparing discharges of 4,482 patients discharged with COPD and CHF diagnoses over six month periods before and after the program was established. The adjusted odds of readmission among patients in the post-discharge group was 24.3% lower than the patients seen in the time period before the post-discharge call period (AOR=0.785, 95% CI 0.68-0.90, p-value=0.0007). The crude rate of patients readmitted decreased from 26.9% to 22.5%, a reduction of 4.4% (p-value=0.0009) in a population that was similar at baseline. Based on these findings, a remotely operated program in which a post-discharge call is made to COPD and CHF patients both clinically and statistically reduces 30-day hospital readmissions.

Rights

All rights reserved. Copyright is held by the author.

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