Impact of a national campaign on hospital readmissions in home care patients.

OBJECTIVE Assess impact of nationwide home health quality improvement campaign to reduce acute care hospitalization of home health recipients. DESIGN Observational pre-post comparison of self-selected participating and non-participating agencies' quality performance; survey to determine uptake of program materials. SETTING US home health care agencies. PARTICIPANTS A total of 147 agencies with 147 non-participating agencies matched on patient length of service, pre-intervention hospitalization rate and pre-intervention rate of change in hospitalization rate. INTERVENTION(S) Public events; provision of educational packages and technical assistance; quality measure feedback. MAIN OUTCOME MEASURE(S) Post-intervention difference in risk-adjusted acute care hospitalization rate between participants and non-participants; difference in self-reported campaign material use between agencies whose hospitalization rate declined 2% or more and those whose rates increased by 2% or more. RESULTS Hospitalization rate had a negative trend beginning before the campaign. In the matched pairs studied, it did not differ significantly between participants and non-participants, or from pre- to post-intervention period (28% in every case). Agencies that improved were more likely to report activities consistent with the campaign and using campaign interventions than those not improving (P < 0.001), regardless of participation status. CONCLUSIONS Merely agreeing to participate in the campaign did not improve performance, but effective participation through adoption of campaign methods did.