apparently successful new health service at one hospital. Why does it work? Will it work as well elsewhere? Has it been thoroughly evaluated? What are the challenges for dissemination elsewhere?
Heart Failure Program Has Reduced Readmissions by 30 Percent - NYTimes.com
I'm very impressed by the story described in this NYT article. I'm curious about two things:
ReplyDelete(1) Based on the model used by UCSF, which seems like it's a lot of labor-intensive provider-patient/family and patient education, how does reimbursement work?
(2) I wonder if this model of providing time and extensive patient education to help patients manage their condition once they exit health care settings could be used to treat other health problems. For instance: STDs (e.g. reducing risk of re-infections), asthma, epilepsy, etc.
But I'm kind of left wondering... shouldn't this approach to providing medical care ("really getting to know the person, before you treat the patient") be the standard norm to begin with?
The three major hospital systems in Monroe County recently began a similar program targeting readmissions among patients with diabetes and respiratory and cardiac conditions. They're using a model developed in Colorado called the Care Transitions Intervention, which employs coaches who help patients at the time of discharge and after they are home to manage their care.
ReplyDeleteThis program is coordinated by the Finger Lakes Health Systems Agency, the regional health care planning group, and includes the two dominant local insurers, as well as the hospitals, the two largest home care agencies, Monroe County and other organizations.
The involvement of the insurers, which is common for initiatives like this in Rochester, indicates that there is some agreement regarding reimbursement. This intervention is linked to the local push (also involving the insurers) for the medical home model, which is also aimed at reducing costs.
I agree with Michael that this approach to care should be more the norm. And it will have to be more so as patients are increasingly expected to manage more of their own care and to spend more of their recovery at home.