Impact of medication bedside delivery program on hospital readmission rates

Abstract

Background: Since the establishment of the Hospital Readmission Reduction Program by the Centers for Medicare and Medicaid Services, reducing readmission rates has been a priority for health care institutions. Many institutions have developed services to combat high readmission rates, including bedside medication delivery programs, which have demonstrated reductions in 30-day readmission rates in patients who used these services.

Objective: To evaluate the impact of health system-based bedside medication delivery programs on readmission rates in patients at a low to moderate risk of hospital readmission.

Methods: A single-center retrospective cohort study conducted on adult patients of low-to moderate-transitions of care (TOC) risk status with unplanned admissions to a large academic medical center between January 1, 2017, and January 1, 2019 who used the medication bedside delivery service or an outside pharmacy. The TOC risk status was defined using historic institutional definitions. Patients with at least a 2-day hospital stay and who were discharged to home from select primary medical services were included. The primary outcome was 30-day readmission rates between the 2 groups. Secondary outcomes included 60- and 90-day readmission rates and readmission rates stratified by primary medical service and TOC status. Coarsened exact matching was used to account for variation between groups.

Results: The study evaluated 6583 patients discharged with a total of 3905 patients and corresponding index admissions meeting inclusion criteria for analysis. No statistically significant difference between readmission rates at 30 days after the index admission was found between the medication bedside delivery group and the outside pharmacy group, 7.97% and 10.09%, respectively (P = 0.136). However, the readmission rate of the medication bedside delivery group was statistically significantly lower than that of the outside pharmacy group at 60 and 90 days.

Conclusions: This study suggests that bedside medication delivery programs do not significantly reduce readmission rates at 30 days but may do so at 60 and 90 days.