Gil Monika, Mikaitis Dana K, Shier Gayle, Johnson Tricia J, Sims Shannon
Department of Pharmacy, Rush University Medical Center, 1653 W. Congress Pkwy., Atrium 0036, Chicago, IL 60612. USA
J Manag Care Pharm. 2013 Sep;19(7):558-63. doi: 10.18553/jmcp.2013.19.7.558.
The Patient Protection and Affordable Care Act (2010) directed the Centers for Medicare and Medicaid Services to implement a hospital readmissions reduction program that reduces payments to hospitals for excess readmissions that began in October 2012. As such, hospitals across the country have been trying to identify and implement successful strategies for reducing hospitalizations.
To evaluate the impact of a combined pharmacist and social worker program on reducing 30-day, all-cause readmission rates to the same hospital.
Our study design was a retrospective, cross-sectional study that included 100 inpatients discharged from a large academic medical center. Fifty patients were enrolled in the combined pharmacist and social worker program, and 50 received usual care; all were deemed high risk for readmission due to clinical or social factors. In the program group, a pharmacist performed a thorough medication history and review of discharge medications and, in some cases, communicated with the patient after discharge. The program group was also followed by a social worker team in the hospital and after discharge; as necessary, psychosocial interventions were performed.
The 2 patient cohorts had similar demographic and clinical characteristics. Ten percent of patients enrolled in the combined pharmacist and social worker program were readmitted to the hospital for any reason within 30 days of discharge, compared with 30% of patients in the usual care group (P = 0.012).
The combined pharmacist and social worker program demonstrated a significant reduction in 30-day, all-cause readmission rates to the same hospital.
《患者保护与平价医疗法案》（2010年）指示医疗保险和医疗补助服务中心实施一项医院再入院率降低计划，该计划从2012年10月起减少对因超额再入院的医院的支付。因此，全国各地的医院一直在努力确定并实施降低住院率的成功策略。
评估药剂师与社会工作者联合计划对降低同一家医院30天全因再入院率的影响。
我们的研究设计为回顾性横断面研究，纳入了从一家大型学术医疗中心出院的100名住院患者。50名患者参加了药剂师与社会工作者联合计划，50名接受常规护理；由于临床或社会因素，所有患者均被视为再入院高风险患者。在计划组中，一名药剂师进行了全面的用药史调查并复查了出院用药，在某些情况下，出院后还与患者进行了沟通。计划组在住院期间及出院后还接受了一个社会工作者团队的跟踪；必要时，进行心理社会干预。
两个患者队列具有相似的人口统计学和临床特征。参加药剂师与社会工作者联合计划的患者中有10%在出院后30天内因任何原因再次入院，而常规护理组为30%（P = 0.012）。
药剂师与社会工作者联合计划显示同一家医院30天全因再入院率显著降低。
