J Healthc Qual. 2022;44(4):194-200. doi: 10.1097/JHQ.0000000000000335. Epub 2022 Mar 23.
Hospital readmission of a primary diagnosis can have a substantial financial impact via reductions in reimbursement rates up to 3%, and have a negative impact on the lives of patients. Discharge medication reconciliation (DMR) can reduce medication errors that play a role in readmission. The objective of this study is to evaluate the impact of expanding pharmacist-led DMR across a four hospital health system on 30-day readmission rate for high risk of readmission disease groups.
During the 3-month period, DMR was performed for patients with at least one of the disease states associated with a high risk for 30-day readmission, including chronic obstructive pulmonary disease, pneumonia, congestive heart failure, or acute myocardial infarction.
The 30-day readmission rate for patients with a high risk for readmission disease state significantly decreased from 17.5% to 15.5% in the pre-expansion to postexpansion phase, respectively ( p = .003). Discharge medication reconciliation capture rate increased from 28% pre-expansion to 35% postexpansion. After expansion, the number of DMR interventions reported by pharmacists increased 2.93 times.
Expansion of pharmacist-led DMR as a form of transitions of care significantly decreased 30-day readmission rate for high risk of readmission disease groups.
主要诊断的医院再入院可能会通过降低高达 3%的报销率对财务产生重大影响，并对患者的生活产生负面影响。出院药物重整（DMR）可以减少导致再入院的药物错误。本研究的目的是评估在一个拥有 4 家医院的医疗系统中扩展药剂师主导的 DMR 对高再入院风险疾病组 30 天再入院率的影响。
在 3 个月的时间里，对至少有一种与 30 天再入院风险高相关的疾病状态的患者（包括慢性阻塞性肺疾病、肺炎、充血性心力衰竭或急性心肌梗死）进行 DMR。
高再入院风险疾病状态患者的 30 天再入院率从扩展前的 17.5%显著下降至扩展后的 15.5%（p=0.003）。出院药物重整捕获率从扩展前的 28%增加到扩展后的 35%。扩展后，药剂师报告的 DMR 干预次数增加了 2.93 倍。
作为一种过渡护理形式的扩展药剂师主导的 DMR 显著降低了高再入院风险疾病组的 30 天再入院率。
