Healthcare News & Insights

Home visits improve outcomes after heart surgery

With all the focus on technology’s role in patient care, it’s important not to forget how successful traditional strategies can be. Example: New research shows readmission rates for one common type of surgery can be reduced by going back to a tried-and-true approach to health care: the home visit. 

ThinkstockPhotos-86520291Specifically, when a physician assistant (PA) made two house calls to patients who had heart surgery the week after they were discharged from the hospital, readmission rates decreased.

According to a press release from the Society of Thoracic Surgeons, researchers from New York’s Staten Island University Hospital, led by Dr. John Nabagiez, reviewed data for almost 2,000 patients who received cardiac surgery. Some were visited by PAs at home, and others were part of a control group who weren’t.

The control group had a significantly higher chance of being readmitted than the patients who received home visits. In fact, there was a 41% reduction in 30-day readmissions for the group of patients who had home visits.

Know thy patient

One factor that likely contributed to the success of the PAs’ home visits: familiarity with patients. The hospital didn’t opt to have PAs from an outside agency conduct home visits. Rather, the PAs who followed up with patients at home were closely involved in the surgery process from start to finish.

“The physician assistants who made the house calls in our study were fully trained cardiac surgery PAs who were actively involved in the preoperative, intra-operative and postoperative care of our patients,” said Dr. Nabagiez in the press release.

Dr. Nabagiez continued, “Unlike standard visiting nurses, our PAs knew each patient personally and understood all of the pertinent issues of the patient’s medical history. They also knew the patient’s individual postoperative course prior to discharge, so they entered the patient’s home already knowing the concerns, if any, of the surgeon and the patient.”

This makes it clear that prior knowledge of patients and their conditions at discharge was crucial to successful house calls. Having this knowledge made it easier for PAs to spot problems earlier, which reduced the likelihood of a patient developing a post-surgical complication that required an additional hospital stay.

The in-home follow-ups also helped patients be more compliant with their aftercare regimen, including taking their medications as prescribed and receiving physical therapy.

Cost-saving measure

Not only did home visits improve patients’ recovery and lowered readmissions, they also saved money, even considering the financial investment the hospital made in the program.

The total cost of the house call program was $23,500. And it saved an estimated $977,500 in readmission costs. In all, house calls saved $39 for each dollar spent.

Budgeting the funds to make house calls to patients after they’ve left the hospital could be a worthwhile investment that improves patient engagement and recovery. It might be time to consider whether your hospital has the resources available to offer similar in-home services to patients.

With the growing focus on the continuum of care, and hospitals’ responsibility to keep patients healthy, home visits could bolster your facility’s strategy for improving quality and value.

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