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Scholarly Commons > HCA Healthcare Journal > Vol. 2 > Iss. 3 (2021)

 

Keywords

transitions of care; bedside medication delivery; patient readmission; hospitalization; medication adherence; pharmaceutical services; prescriptions; medication therapy management; disease management

Disciplines

Other Pharmacy and Pharmaceutical Sciences

Abstract

ABSTRACT

Background

While the benefits of bundled transitions of care services are understood, only a limited number of studies have analyzed the impact of a stand-alone bedside medication delivery service on repeat hospital encounters, and those published have reported mixed results.

Methods

A retrospective analysis was conducted in medical and surgical patients at a large community hospital. Adult patients discharged from either the cardiology, medicine, pulmonary, orthopedic/spine surgery, or women’s surgery unit and prescribed at least one new prescription upon discharge to home between September 2015 and March 2018 were included. The primary objective was to compare unplanned 30-day re-presentation rates in patients who received Meds to Beds services to those who did not. The secondary objective was to compare 30-day re-presentation rates by patient type. Re-presentation was defined as an inpatient admission, emergency department visit, or observational encounter for any diagnosis within the six-hospital health system. Chi-square and logistic regression tests were used to assess statistical significance, and the study was powered to detect a difference in the primary objective.

Results

A total of 45,546 patients were included. Of those, 4,286 received Meds to Beds services (Intervention Group, IG) while 41,260 patients did not (Control Group, CG). Overall 30-day re-presentation rate was not statistically different (15% IG versus 15.3% CG, OR 1.0; 95% CI 0.9-1.1; p = 0.76). However, the 30-day re-presentation rate was statistically lower for women’s surgery (12.8% IG versus 15.6%, CG p = 0.03, NNT 36) and orthopedics/spine surgery patients (7.3% IG versus 10.2% CG, p < 0.01, NNT 34).

Conclusion

While there was no statistically significant differences in overall 30-day re-presentation rates, there were significant reductions in two surgical patient subgroups. Avoidance of re-presentations and generation of prescription revenue outweighed program costs.

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