Date of Conferral



Doctor of Healthcare Administration (D.H.A.)


Health Services


Miriam Ross


The impact of hospital readmissions on an organization includes reimbursement penalties, elevated mortality and morbidity rates, increased health care expenditures, and poor quality of life for the community’s residents. This study examined the impact of an integrated care transitions program on the 30-day readmission rates for heart failure and chronic obstructive pulmonary disease (COPD) within an independent rural community health care organization in Middle America. The two research questions pertained to the relationships pre-and post-implementation of this program to the 30-day readmission rates for these two disease processes. The Donabedian model examined the structure and function of an integrated care transitions program and 30-day readmission outcomes. Data from the Vizient Clinical Data Base were analyzed to determine the association between the variables using the Mann-Whitney U and Bayesian Regression test, including one-way ANOVA. The rate of 30-day readmission for both heart failure and COPD patients was reduced after the implementation of the integrated care transitions program and therefore the null hypotheses were rejected. Research recommendations include exploring the readmission patterns for other diseases and within different health care settings. This study may guide health care administrators in understanding the impact of an integrated care transitions program on 30-day readmission rates. This understanding may also highlight health care disparities and challenges of providing health care within rural health care settings leading to positive social change through the development of programs focused on care transitions and the delivery of patient-centered care resulting in the reduction of cost for patients and health care organizations.