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Lay-health workers reduce readmission rates in new study

Readmissions cost the healthcare system an estimated $17 billion annually and the majority are avoidable.

Jeff Lagasse, Associate Editor

A recent study published in Health Education Research suggests that lay-health workers may be able to significantly reduce readmissions rates to hospitals for high-risk patients following surgery.

A lay-health worker is someone who has received some training to promote health, or to carry out some basic healthcare services, and who acts as a link between formal health services and patients, especially those at high risk. In the U.S., lay-health worker programs first emerged as part of the Great Society domestic policies in the 1960s.

[Also: How Intermountain empowers families in clinical care to reduce readmissions]

Their potential impact on readmissions rates carries financial implications for hospitals. To promote quality of care, the federal government levies monetary penalties against hospitals and health systems that leg behind their peers when it comes to 30-day readmission rates. According to Loopback Analytics, hospitals were penalized about $108 million more in 2017 than in the previous year for readmissions alone.

Lay-health workers, who perform specific, delineated tasks, like assisting during medical appointments and providing access to transportation, can be deployed much faster than more highly-trained health professionals, the study found. Often, they can improve patient experiences through culturally sensitive, community-based health services. They also serve as a resource for patients attempting to obtain health education or navigate the healthcare system.

Patients, who are often uncertain and vulnerable when discharged after a long hospitalization, often shift from being dependent and complacent while hospitalized to having significant responsibilities, which can potentially affect their risks for readmission, according to the authors. Roughly 20 percent of all Medicare fee-for-service patients are readmitted within 30-days of hospital discharge, costing the healthcare system an estimated $17 billion annually. The majority of these readmissions are avoidable.

The aim of the research was to reduce 30-day hospital readmission rates in a community hospital in Kentucky using lay-health workers to assess and assist hospitalized high-risk patients. The study was conducted in St. Claire Regional Medical Center in Morehead. Hospitalized patients at high-risk of a 30-day readmission to the hospital were targeted; those patients included men and women over 18 years old of any racial/ethnic group and admitting diagnosis. This group was identified as high-risk given their medical history and health problems.

In all, there was a 47.7 percent relative reduction of 30-day hospital readmissions rates during the period studied. Simple regression analyses demonstrated a 56 percent decrease in the odds of being readmitted within 30-days, and once adjusting for education, transportation costs and anxiety symptoms, there was a 77 percent decrease those odds among those exposed to the lay-health program.

Twitter: @JELagasse
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