The influence of community support services in reducing potentially preventable readmissions

The Influence of Community Support Services in Reducing Potentially Preventable Readmissions by Camille Rose Bash M.B.A., University of Missouri in St. Louis, 1980 M. A. , Webster University, 1978 B.B.A., University of Texas, 1975 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Policy and Administration Walden University November 2013 Abstract Recently, the Centers for Medicare and Medicaid Services (CMS) ranked all hospitals based on Medicare readmission rates for heart attacks, heart failure, and pneumonia. CMS offered subsidies to hospitals ranked in the 4th quartile to develop community support services to reduce the problem of potentially preventable readmissions (PPRs). CMS cited 4 of the 5 hospitals in Prince George’s County in the 4 quartile. The purpose of this quantitative research study was to investigate the relationship between communityRecently, the Centers for Medicare and Medicaid Services (CMS) ranked all hospitals based on Medicare readmission rates for heart attacks, heart failure, and pneumonia. CMS offered subsidies to hospitals ranked in the 4th quartile to develop community support services to reduce the problem of potentially preventable readmissions (PPRs). CMS cited 4 of the 5 hospitals in Prince George’s County in the 4 quartile. The purpose of this quantitative research study was to investigate the relationship between community support services and the reduction of PPRs in Prince George’s County. The Evans and Stoddart field model of health and well-being guided this study with support from Bertalannffy’s general systems theory. This study sought to relate community support services to PPRs in Prince George’s County in contrast to other Maryland counties. To evaluate relationships between community support services and the reduction of PPAs, secondary data were provided by CMS in conjunction with the Robert Wood Johnson Foundation and the University of Wisconsin. The data included 26 behavioral community support factors from 53,229 Medicare paid claims in Maryland residents from July 1, 2008 to June 30, 2011. Lack of diabetes screening is a community support factor within quality of care. Using multiple regressions, there was a statistically significant relationship found between diabetic screenings and pneumonia readmission rate. The implication for social change is that reimbursement of key screening recommendations to CMS, local government, and hospitals in Prince George’s County may reduce readmission rates, thereby positively affecting patients, improving community health, and decreasing health care costs in Prince George’s County. The Influence of Community Support Services and in Reducing Potentially Preventable Readmissions by Camille Rose Bash M.B.A., University of Missouri in St. Louis, 1980 M.A., Webster University, 1978 B.B.A., University of Texas, 1975 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Policy and Administration Walden University November 2013 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. Microform Edition © ProQuest LLC. All rights reserved. This work is protected against unauthorized copying under Title 17, United States Code ProQuest LLC. 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, MI 48106 1346 UMI 3602920 Published by ProQuest LLC (2013). Copyright in the Dissertation held by the Author. UMI Number: 3602920 Dedication To my family, I owe so much. They allowed me to focus on this subject so a quality research project would add to the common body of literature on the prevention of unnecessary readmissions. In addition, thanks to my friends and colleagues who read drafts and provided advice in the development of this topic. Acknowledgments Thanks to the members of my committee. My Chairman, Dr. Lori Demeter, assisted me in developing a quality research study, Dr. Raj Singh provided guidance on the methodology, and Dr. Kirk Williams offered improvements to ensure the paper added to the common body of knowledge. I want to thank Dr. Sarah Hart, my first Committee Chairman, who assisted in the design that was appropriate for a dissertation. Finally, I want to thank Wendy LaRue and Timothy McIndoo, who served as my editors.