Improving the communication and coordination of primary care and hospitals is commonly known as vertical integration, and was found to be effective in reducing hospital readmission. In a study, published in in Medical Care, researchers analyzed the vertical integration of healthcare in Portugal which led to reduced hospital readmissions for a variety of conditions.

From 1999 to 2001, Portuguese Ministry of Health combined primary care and public hospitals to create Local Health Units (LHUs) to improve efficiency and effectiveness. The vertical integration of the healthcare system, while also used in other countries, is scarce in its research into the benefits it provides. Led by Sílvia Lopes, PhD, and colleagues of NOVA National School of Public Health, Universidade NOVA de Lisboa, the study aims at providing evidence on how the vertical integration affects healthcare outcomes and patient care.

The study evaluated an unplanned 30-day readmissions before and after the implementation of vertical integration from 2004 to 2013 in six hospitals. Results showed that readmission rates at vertically integrated hospitals were measured at 4.8 percent compared to 5.4 percent from the control group. Readmission rate improvement was shown to have a 30 percent reduction in patients previously admitted with diabetic complications, urinary tract infections and pneumonia.

"Given that reducing readmissions was not an explicit goal of the policy, the findings suggest the potential of vertical integration and the resulting increased care coordination to reduce readmissions," said Lopes. "These findings suggest that vertical integration can have a positive impact, but there are still challenges to be addressed regarding the success of vertical integration in reducing 30-day hospital readmissions.”