SAU Economics Prof Published in JAMA


Dr. Jim Bang Contributes to Patient Readmission Study Published in Journal of the American Medical Association

After being discharged from a hospital or emergency room, some patients end up returning for a variety of reasons. A team of researchers investigated this costly issue and began surveying patients and nurses to determine if the patient is ready to leave the hospital.

Between 2014 and 2017, the study included 33 Magnet-designated hospitals and more than 144,000 adult patients from 66 patient care units who were discharged and used the Readiness Evaluation and Discharge Intervention (READI) questionnaire comprised of eight questions. As a result, hospitals readmitted approximately 2,577 fewer patients (a 1.79 percent decrease) in that time period.

James T. Bang, PhD, Economics professor at St. Ambrose University, contributed data analysis and data interpretation to this study.

"The strongest effect of the study," Bang said, "was when both nurse and patient completed the survey, and when the nurses then used that information to help determine what kinds of discharge recommendations they can make to improve the patient's outcome once they leave."

The study was published Jan. 25 in the Journal of the American Medical Association titled "Effect of Implementing Discharge Readiness Assessment in Adult Medical-Surgical Units on 30-Day Return to Hospital: The READI Randomized Clinical Trial." Read the study here.

"In high readmission settings, we found that adding tools for nurses to evaluate patient readiness for discharge helped to reduce readmissions in the first 30 days of hospital discharge," said principal investigator, Marianne Weiss, DNSc, RN, professor of Nursing at Marquette University, Milwaukee.

The need to lower patient readmissions stems from October 2012 when the Affordable Care Act authorized the reduction of Medicare payments to hospitals with readmissions that surpassed a certain ratio. According to Medicare, this ratio was determined by the number of "predicted" 30-day readmissions and the number of "expected" which was based on an average hospital with similar patients.

The questionnaire captures four dimensions of readiness: physical readiness and energy; knowledge of restrictions and which problems to watch out for; feeling able to handle demands at home as well as personal care; and how much support they expect to have with personal and medical care.

The research team included nurses and economist researchers from the University of Michigan, Loyola University-Chicago, University of Maryland-Baltimore, University of South Carolina, Abt Associates, and St. Ambrose University.

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