Systematic Review of Ambulatory Transitional Care Management (TCM) Visits on Hospital 30-Day Readmission Rates

Authors

Karen L. Roper, University of KentuckyFollow
Jonathan Ballard, University of KentuckyFollow
Wade Rankin, University of KentuckyFollow
Roberto Cardarelli, University of KentuckyFollow

Abstract

To reduce readmission rates and prevent adverse outcomes after discharge, hospitals have begun implementing "transitional care" initiatives. This systematic review identifies research on the particular set of services now reimbursable by Medicare (transitional care management [TCM]) and evaluates the studies for program effectiveness. Results of 3 databases were screened for peer-reviewed journal articles published between January 2004 and 2015 that report on readmissions of adults in the US health care system under the Medicare TCM bundle. ClinicalTrials.gov was queried for funded studies. Of 969 identified studies, 77 met inclusion criteria for relevance to transitional care and appropriateness of population and setting. Of these, only 3 articles incorporated all required elements for TCM service. Although 2 were program improvement designs and none were randomized controlled studies, each report reduced readmission rates. Evidence for TCM effectiveness is limited. Additional study of TCM implementation and programmatic support for TCM is warranted.

Document Type

Article

Publication Date

12-1-2015

Notes/Citation Information

Published in American Journal of Medical Quality, v. 32, issue 1, p. 19-26.

The copyright holder has granted the permission for posting the article here.

The document available for download is the authors' post-peer-review final draft of the article. The figure, tables, and appendix are available as the additional files listed at the end.

Digital Object Identifier (DOI)

https://doi.org/10.1177/1062860615615426

Repository Citation

Roper, Karen L.; Ballard, Jonathan; Rankin, Wade; and Cardarelli, Roberto, "Systematic Review of Ambulatory Transitional Care Management (TCM) Visits on Hospital 30-Day Readmission Rates" (2015). Family and Community Medicine Faculty Publications. 3.
https://uknowledge.uky.edu/familymedicine_facpub/3