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Reducing Hospitalizations and Costs: A Home Health Nutrition‐Focused Quality Improvement Program
Author(s) -
Riley Katie,
Sulo Suela,
Dabbous Firas,
Partridge Jamie,
Kozmic Sarah,
Landow Wendy,
VanDerBosch Gretchen,
Falson Mary Kay,
Sriram Krishnan
Publication year - 2020
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1002/jpen.1606
Subject(s) - medicine , propensity score matching , malnutrition , health care , quality management , emergency medicine , pediatrics , operations management , management system , economics , economic growth
Background Identification and treatment of malnutrition across the care continuum can help prevent illness onset or relapse and maximize the effectiveness of other medical treatments. This study aimed to evaluate the effect of a nutrition‐focused quality improvement program (QIP) conducted in a home health agency (HHA) on hospitalization rates and healthcare costs incurred over 90 days. Methods This was a multisite, pre‐post QIP implemented at 2 branches of an Illinois‐based HHA. The QIP included 1546 patients who were (1) at‐risk or malnourished hospitalized patients discharged to the HHA, (2) referred by a physician during an outpatient visit, or (3) enrolled in the HHA through a skilled nursing facility. A historic (n = 7413 patients) and concurrent group (n = 5235) of patients were used for comparisons. Propensity score matching was used to account for imbalances in patient characteristics. Results The QIP led to reduced relative risk of hospitalization post‐enrollment to the QIP by 24.3%, 22.8%, and 18.3% at 30, 60, and 90 days, respectively, when compared with the historic group, and by 18.2%, 16.2%, and 12.1% when compared with the concurrent group. Total cost savings from reduced 90‐day healthcare resource utilization was $2,318,894, or $1500 per patient treated. Conclusions Rates of hospitalization and healthcare resources can be significantly reduced through the implementation of a nutrition‐focused QIP delivering oral nutritional supplements in home health settings for adults at‐risk/malnourished. These results highlight the importance of nutrition as a strategy for HHAs and other post‐acute care institutions to improve patients' health outcomes and generate cost savings.