Intervention by a clinical pharmacist carried out at discharge of elderly patients admitted to the internal medicine department: influence on readmissions and costs

BMC Health Services Research

Juana Benedí González¹  José Antonio Romero Garrido²  José Manuel Caro Teller³  José Miguel Ferrari Piquero³  Carmen García Muñoz³  Andrea Lázaro Cebas⁴  Carlos González Gómez⁵  Carlos Lumbreras Bermejo⁵ 

[1] Pharmacology Department. Facultad de Farmacia, Universidad Complutense, Madrid, Spain;Pharmacy Department Hospital, Universitario La Paz, Madrid, Spain;Pharmacology Department. Facultad de Farmacia, Universidad Complutense, Madrid, Spain;Pharmacy Department. Hospital, Universitario 12 de Octubre, Madrid, Spain;Pharmacy Management Department. Dirección General de Asistencia Sanitaria, Servicio Murciano de Salud, Murcia, Spain;Servicio de Medicina Interna Hospital Universitario 12 de Octubre, Madrid, Spain;

关键词: Pharmacists;    Patient readmission;    Aged;    Polypharmacy;    Cost analysis;   

DOI  :  10.1186/s12913-022-07582-6

来源: Springer

【 摘 要 】

BackgroundPatient education on pharmacological treatment could reduce readmissions. Our objective was to carry out a pharmacist intervention focused on providing information about high-risk medications to chronic patients and to analyse its influence on readmissions and costs.MethodsA single-centre study with an intervention group and a retrospective control group was conducted. The intervention was carried out in all polymedicated patients ≥ 65 years who were admitted to internal medicine and signed the informed consent between June 2017 and February 2018. Patients discharged to nursing homes or long-term hospitals were excluded. The control group were all the patients who were admitted during the same months of 2014 who met the same inclusion criteria. The patients were classified according to the HOSPITAL score as having a low, intermediate, or high risk of potentially avoidable readmission. Outcome measures were 30-day readmission and cost data. To analyse the effect of the intervention on readmission, a logistic regression was performed.ResultsThe study included 589 patients (286 intervention group; 303 control group). The readmission rate decreased from 20.13% to 16.43% in the intervention group [OR = 0.760 95% CI (0.495–1.166); p = 0.209)]. The incremental cost for the intervention to prevent one readmission was €3,091.19, and the net cost saving was €1,301.26. In the intermediate- and high-risk groups, readmissions were reduced 10.91% and 10.00%, and the net cost savings were €3,3143.15 and €3,248.71, respectively.ConclusionsThe pharmacist intervention achieved savings in the number of readmissions, and the net cost savings were greater in patients with intermediate and high risks of potentially avoidable readmission according to the HOSPITAL score.

【 授权许可】

CC BY