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Clinical Trials Update
March 24/31, 2020

Hotspotting Doesn’t Prevent Hospital Readmissions in Study

JAMA. 2020;323(12):1124. doi:10.1001/jama.2020.2811

An intensive “hotspotting” program designed to reduce unnecessary medical care by so-called superutilizer patients while improving their health failed to prevent hospital readmissions, a trial in the New England Journal of Medicine reported.

The nationally recognized cost-reduction model, created by the Camden Coalition of Healthcare Providers, relies on real-time hospital admissions data—hotspotting—to identify patients with frequent hospital admissions. Following discharge, multispecialty teams conduct home visits, coordinate medical care, and help patients access government benefits and social services. The study randomized 800 hospitalized patients with complex medical and social needs in Camden, New Jersey, to the care-transition program or to usual care.

The intervention did not alter the 180-day readmission rate, which was 62.3% in the care-transition group and 61.7% in the control group. The authors noted that the Camden patients were more complex and had nearly twice the hospital utilization prior to the trial compared with patients in other successful care-transition programs. “The difficulties that this pioneering, data-driven organization had in achieving rapid assistance for patients may portend difficulties in achieving it at scale,” they wrote.