The effects of chronic disease management plans on all-causereadmission costs in stroke: a data linkage study

Background and Aims: General practitioners use chronic disease management plans (CDMPs) to manage the healthcare of people with chronic diseases who require a structured approach. We aimed to determine whether treatment with CDM plans reduces all-cause readmission costs in patients with stroke or TIA.

Methods: Secondary data linkage analyses were conducted using the cohort of the cluster-randomised trial (STAND FIRM). Participants aged 18 years admitted for stroke or TIA were recruited from four hospitals in Melbourne. Person-level data from the trial were linked to datasets on CDM plan use and hospitalisations. Costs of readmissions from index discharge to two years were estimated using information from the 2015 National Hospital Costs Data Collection in AUD. The cost of same-day and multiday readmissions were estimated applying the average cost of same day separations and average cost per day for overnight separations, respectively. Median regression was used to compare read-mission costs between those who used CDMPs for two years and those who did not.

Results: Among 563 participants recruited (median age 70 years, 64% male), 323 used CDMPs and 422 had at least one all-cause readmission within two years after hospital discharge. The median length of stay was three days (interquartile range 2–11 days). The median cost of readmissions was $4,358(interquartile range $2,638-$19,268). The between-group difference was not significant (adjusted forage, sex and comorbidity profile ß ¼ $-1,004, 95% CI $-4,399; $2,391, p value 0.56).

Conclusions: Treatment with CDMPs was not significantly associated with reduced readmission costs in patients with stroke or TIA.