Hospital Readmissions Among the Elderly

Gooding, Judith S.; Jette, Alan M.

doi:10.1111/j.1532-5415.1985.tb06315.x

Cited by 191 publications

(78 citation statements)

References 3 publications

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“…Potential non-compliance with advice and failure to seek medical attention when symptoms occur are related to rehospitalization. Thus it can be expected that patients who are able to care for themselves effectively will encounter fewer problems leading to rehospitalization or unnecessary visits to the emergency department [10,[13][14][15][16][17][18] . However, because of increased knowledge about the disease, it is also possible that education and support leads to an increase in health care resource use.…”

Section: Introductionmentioning

confidence: 99%

Effects of education and support on self-care and resource utilization in patients with heart failure

Jaarsma¹

1999

European Heart Journal

319

232

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Aims To test the effect of education and support by a nurse on self-care and resource utilization in patients with heart failure.Methods A total of 179 patients (mean age 73, 58% male, NYHA III-IV) hospitalized with heart failure were evaluated prospectively. Patients were randomized to the study intervention or to 'care as usual'. The supportive educative intervention consisted of intensive, systematic and planned education by a study nurse about the consequences of heart failure in daily life, using a standard nursing care plan developed by the researchers for older patients with heart failure. Education and support took place during the hospital stay and at a home visit within a week of discharge. Data were collected on self-care abilities, self-care behaviour, readmissions, visits to the emergency heart centre and use of other health care resources.Results Education and support from a nurse in a hospital setting and at home significantly increases self-care behaviour in patients with heart failure. Patients from both the intervention and the control group increased their self-care behaviour within 1 month of discharge, but the increase in the intervention group was significantly more after 1 month. Although self-care behaviour in both groups decreased during the following 8 months, the increase from baseline remained statistically significant in the intervention group, but not in the control group. No significant effects on resource utilization were found.Conclusions Intensive, systematic, tailored and planned education and support by a nurse results in an increase in patients' self-care behaviour. No significant effects were found on use of health care resources. Additional organisational changes, such as longer follow-up and the availability of a heart failure specialist would probably enhance the effects of education and support. (Eur Heart J 1999; 20: 673-682)

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Section: Introductionmentioning

confidence: 99%

Effects of education and support on self-care and resource utilization in patients with heart failure

Jaarsma¹

1999

European Heart Journal

319

232

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“…7 Readmission rates of 20% to 27% within 1 year have been reported, 8,9 but none of these studies focused on the subgroup of disabled stroke survivors. Geriatric research documents readmission rates of 25% within 6 months among nonselected elderly patients, 36% among elderly patients with congestive heart failure, 10 and 50% within 1 year among the frail elderly. 11 Readmission of elderly disabled stroke patients, a common occurrence in clinical practice, increases the costs of health care 12 and causes emotional distress for the patient.…”

mentioning

confidence: 99%

Can Readmission After Stroke Be Prevented?

Andersen

Schultz‐Larsen

Kreiner

et al. 2000

Stroke

108

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Background and Purpose-About 50% of stroke survivors are discharged to their homes with lasting disability.Knowledge, however, of the importance of follow-up services that targets these patients is sparse. The purpose of the present study was to evaluate 2 models of follow-up intervention after discharge. The study hypothesis was that intervention could reduce readmission rates and institutionalization and prevent functional decline. We report the results regarding readmission. Methods-This randomized study included 155 stroke patients with persistent impairment and disability who, after the completion of inpatient rehabilitation, were discharged to their homes. The patients were randomized to 1 of 2 follow-up interventions provided in addition to standard care or to standard aftercare. Fifty-four received follow-up home visits by a physician (INT1-HVP), 53 were provided instructions by a physiotherapist in their home (INT2-PI), and 48 received standard aftercare only (controls). Baseline characteristics for the 3 groups were comparable. Six months after discharge, data were obtained on readmission and institutionalization. Results-The readmission rates within 6 months after discharge were significantly lower in the intervention groups than in the control group (INT1-HVP 26%, INT2-PI 34%, controls 44%; Pϭ0.028). Multivariate analysis of readmission risk showed a significant favorable effect of intervention (INT1-HVP or INT2-PI) in interaction with length of hospital stay (Pϭ0.0332), indicating that the effect of intervention was strongest for patients with a prolonged inpatient rehabilitation. Conclusions-Readmission is common among disabled stroke survivors. Follow-up intervention after discharge seems to be a way of preventing readmission, especially for patients with long inpatient rehabilitation. (Stroke.

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“…Estudios en los Estados Unidos informan de tasas de reingresos por IC que varían ampliamente según la población a estudio, metodología utilizada y duración del periodo de observación y varían entre 11-14% a los 14 días y 36-44% a los 180 días 1,[4][5] . En España hasta 1996 no existían publicaciones sobre reingresos hospitalarios por IC, el primer trabajo analizó la proporción de reingresos urgentes por un diagnóstico relacionado en 30 días desde el alta hospitalaria y lo cuantificó en 13,6% 34 .…”

Section: Discussionunclassified

“…La insuficiencia cardiaca (IC) se considera como uno de los mayores y más crecientes problemas de salud pública en los países industrializados, con tasas de admisiones hospitalarias que se incrementan progresivamente y se asocian a una elevada frecuencia de reingresos, muchos de ellos considerados potencialmente evitables [1][2][3][4][5] . Una extensa producción científica describe sus características clínico-epidemiológicas 6-10 y cuantifica la tendencia creciente al consumo de recursos sanitarios 7,11 .…”

Section: Introductionunclassified