Summary Findings Presented at Hospital Medicine 2014 in Las Vegas, March 24 – 27; Featured in US News & World Report
Because nearly one in five Medicare patients is readmitted within 30 days of hospital discharge at an estimated annual cost of $26 billion, new rules under the Patient Protection and Affordable Care Act (ACA) apply a “stick” approach to reduce this cost burden. Specifically, Medicare has introduced penalties for hospitals that have high 30-day readmission rates, particularly among patients treated for acute myocardial infarction (AMI), congestive heart failure (CHF) and pneumonia – the three conditions responsible for the most hospital admissions and readmissions.i
While it is well-established that these serious conditions are associated with substantially longer lengths of stay in the hospital, what is less appreciated is the extent to which malnutrition in hospitalized patients contributes to poorer outcomes. Accordingly, a team of researchers from the University of Southern California, Stanford University, The Harris School at The University of Chicago and Precision Health Economics conducted a retrospective study designed to document the value of treating malnourished patients with oral nutrition supplements (ONS), which deliver macronutrients and micronutrients, as a strategy for reducing hospital readmissions.
The findings, discussed in an online op-ed ("Is Nutrition the First Step in Addressing Hospital Readmissions?") published in the March 18, 2014 issue of US News & World Report, and presented during a poster session at Hospital Medicine 2014, the Society for Hospital Medicine’s annual meeting held March 24-27 in Las Vegas, represent an important wake-up call for healthcare providers and the hospital community. Supported with a research grant from Abbott Nutrition, the study used a national database of 44 million adult patient hospital episodes in 460 hospitals between 2000 and 2010 to determine differences in length of stay, episode cost and 30-day readmission rates when Medicare patients aged 65 and older were prescribed ONS versus those not receiving ONS. The results are noteworthy: ONS decreased the probability of 30-day readmission by 12% for AMI and 10.1 percent for CHF; decreased the average hospital length of stay by 16% decrease; and achieved a cost saving per episode of $3,079.
"Hospitals are going to be looking for ways to improve quality of care for Medicare patients in order to lower readmission rates and prevent fines," said study co-author, Tomas Philipson, Ph.D., who is the Daniel Levin Chair of Public Policy at the University of Chicago. "This analysis suggests that use of oral nutritional supplements is a simple and cost-effective solution that hospitals can implement immediately."
Echoing this assessment, Dr. Robert H. Miller, Head of Global Research and Development, Scientific and Medical Affairs for Abbott Nutrition, wrote in the online US News & World Report op-ed: “As our healthcare system continues to face a growing Medicare population and rising costs, something as simple as empowering hospitals and all healthcare practitioners to screen and identify the nutritional status of their patients and educate them on the importance of nutrition, can go a long way in reducing costly health care problems.”
Learn more about this study or review additional data.
i Health Affairs.org, "Will The Readmission Rate Penalties Drive Hospital Behavior Changes?" Feb. 14, 2013
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