In October of 2012, the federal government launched an initiative known as the Hospital Readmissions Program in response to a mandate enacted by the Patient Protection and Affordable Care Act. The aim of this program was to reduce the number of hospital readmissions by imposing financial penalties on hospitals who failed to keep their Medicare readmission rates below the national average.
Although penalties are assessed based on a number of somewhat convoluted metrics, research published by the Kaiser Family Foundation shows a net effect of a decline in readmission rates since the inception of the program. One of the most persistent problem areas that hospitals have encountered in attempting to achieve compliance with the program is readmissions for cardiovascular disease.
Below are some key statistics that highlight the prominence of this issue within the current medical landscape:
- A 2011 study published by the Agency for Healthcare Research and Quality (AHRQ) named congestive heart failure as the number-one cause of Medicare readmissions.
- According to a report published by the American Journal of Medicine, the United States has the highest rate of post-myocardial infarction (i.e., heart attack) readmissions in the world.
- Approximately 1 out of every 4 patients who have been diagnosed with heart failure are readmitted to the hospital within 30 days.
- According to data published by the Centers for Disease Control, congestive heart failure has been responsible for an average of 1 million hospital admissions and readmissions each year.
- According to a 2013 study published by the Journal of the American Medical Association, cardiovascular disease was responsible for 52.8 percent of hospital readmissions after initial hospitalization for heart failure, and 53.4 percent of readmissions after initial hospitalization for acute myocardial infarction.
While there are undoubtedly a multitude of factors that can contribute to this high rate of hospital readmissions for cardiovascular disease, patient-centered factors are frequently cited as a significant variable in terms of predicting and influencing readmission rates. Numerous studies have shown that low patient participation in terms of adhering to recommended diet, exercise and medication regimens is one of the primary reasons for high readmission rates, especially among individuals with chronic conditions.
What is particularly interesting to note is that "psychosocial and socioeconomic factors" also play a significant role in limiting patient adherence and compliance to treatments recommended by health professionals. Examples of this can include language barriers due to diverse ethnicity, low health literacy or lack of availability of appropriate community resources.
While the above factors present significant obstacles to successful health management, solutions do exist that can encourage greater levels of patient participation. The PatientBond automated cloud-based communications platform, for example, leverages the power of psychographic segmentation in order to provide highly relevant messages and interactions that resonate with patients' motivations, values and priorities pertaining to health and wellness. Using this robust platform, hospitals can offer highly personalized post-discharge support for cardiovascular patients.
Regardless of the solution you choose, make sure you take the following steps to help reduce hospital readmission rates for cardiovascular disease:
- Provide patients with educational materials that can promote self-management of their health condition after they have been discharged from the hospital. This should includes information regarding how to maintain a healthy lifestyle, specifically highlighting behaviors that will help them enhance their health status in light of their cardiovascular disease.
However, provide this education in manner that is easy to digest, internalize and act upon. Handing a CHF patient a 60-page educational book at discharge is not the most effective way to ensure a successful recovery. If a patient experiences an emergency, they’re more likely to call 911 than search for an answer through dozens of pages of patient education.
- Offer automated follow-up communications via email, text and Interactive Voice Response (IVR) to remind patients to attend scheduled appointments, check-ups and health screenings.
- Send automated communications to remind patients to refill their prescriptions at scheduled times. Non-adherence to prescribed medication regimens is one of the primary factors influencing high readmission rates for cardiovascular disease. With PatientBond, these communications are personalized using key psychographic insights that will appeal to the individual motivations and values of the patient, strengthening medication adherence and follow-through on clinician recommendations.
- Use surveys to monitor recovery. PatientBond, for instance, enables healthcare organizations to get a pulse on the needs, perceptions, motivations and desires of their patients by providing highly customizable survey building services. Once the survey is designed, it can be sent to contact lists of virtually any size, offering healthcare professionals easy and immediate access to key consumer insights without reliance upon third parties. Keeping these surveys short is key to maximizing patient response.
While it's true that a variety of measures must be taken in order to reduce or prevent hospital readmissions for cardiovascular disease, the task is far from impossible. By combining the power of consumer psychology and adaptive technology, an automated solution such as PatientBond can help healthcare organizations significantly reduce readmission rates while fostering an environment for more positive health outcomes.