Missed Opportunities in Preventing Hospital Readmissions: Redesigning Post-Discharge Checkup Policies

• Main Authors: Helm, J.E (Author), Hu, M. (Author), Lavieri, M.S (Author), Liu, X. (Author), Skolarus, T.A (Author)
• Format: Article
• Language: English
• Published: Wiley-Blackwell 2018
• Subjects: disease screening; hospital readmissions; machine maintenance delay-time model; telemedicine
• Online Access: View Fulltext in Publisher

 Hospital readmissions affect hundreds of thousands of patients every year, negatively impacting patients and placing a tremendous burden on the national healthcare system. Post-discharge checkup policies can reduce readmissions through early detection of health conditions, however, the methods behind designing effective checkup policies are poorly understood. Under current practice, up to 67% of readmitted patients return to the hospital before their first scheduled office visit. This work aims to develop effective checkup plans to monitor patients following hospital discharge, using a variety of checkup methods, including phone calls and office visits. We develop and analyze a new delay-time analysis model to identify the optimal type and timing of checkups to implement post-discharge monitoring plans. By analyzing the structure of optimal policies, we develop checkup schedules that can detect up to 43.7% more readmission-causing conditions experienced by readmission-bound patients. Further, we uncover simple rules of thumb that can help doctors design and improve monitoring plans even in the absence of advanced computer software or complex computations. © 2018 Production and Operations Management Society