Through the program, a social worker calls or visits a recently discharged patient to determine how that patient feels, ascertains whether or not the patient is following prescribed instructions and therapies and identifies barriers to patient health.
The study, which tracked 100 patients, found readmissions were reduced from 15 percent to 7 percent over a two-year time period.
The program was developed by researchers at Binghamton University’s College of Community and Public Affairs in Vestal, N.Y., and at SUNY Upstate Medical University in Syracuse.
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