Can targeting high-risk patients reduce readmission rates? Evidence from Israel. Issue 1 (1st January 2020)

• Record Type: Journal Article
• Authors: Shadmi, Efrat; Zeltzer, Dan; Shir, Tzvi; Flaks-Manov, Natalie; Einav, Liran; Balicer, Ran D.
• Is Part Of: Journal of applied economics. Volume 23:Issue 1(2020)
• Page Start: 729
• Page End: 745
• Publication Date: 2020-01-01
• Subjects: Healthcare -- hospital readmissions -- predictive modeling; Economics -- Periodicals; Economic policy -- Periodicals; Finance -- Periodicals; Economic policy; Economics; Finance; Electronic journals; Electronic journal; Periodicals; 330.05
• DOI: 10.1080/15140326.2020.1798194
• Languages: English
• ISSNs: 1514-0326

Abstract

ABSTRACT: We study a large intervention intended to reduce hospital readmission rates in Israel. Since 2012, readmission risk was calculated for patients aged 65 and older, and high-risk patients were flagged to providers upon admission and after discharge. Analyzing 171, 541 admissions during 2009–2016, we find that the intervention reduced 30-day readmission rates by 5.9% among patients aged 65–70 relative to patients aged 60–64, who were not targeted by the intervention and for whom no risk-scores were calculated. The largest reduction, 12.3%, was among high-risk patients, though some of it may reflect substitution of attention away from patients with unknown high-risk at the point of care. Post-discharge follow-up encounters were significantly expedited. Estimated effects declined after incentives to reduce readmission rates were discontinued. The evidence demonstrates that informing providers about patient risk in real-time coupled with incentives to reduce readmissions can improve care continuity and reduce hospital readmissions.