Risks for unplanned hospital readmission in a teaching hospital in southern Taiwan

Chang, Su-Hsien; Chiu, Ya Hung; Liou, I-Ping

doi:10.1046/j.1440-172x.2003.00443.x

Cited by 8 publications

(12 citation statements)

References 22 publications

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“…Räty et al 2003). It has been reported that home-care clients use a lot of other services, in addition to home care, such as visits to doctors and to the emergency department, as well as periods in institutions (Andersson et al 2005;Smith et al 2005;Furhoff 2002, 2004;Chang et al 2003). According to Noro et al (1999), women were more likely to use health-care services, but their share of total expenditure was lower than that of men.…”

Section: Introductionmentioning

confidence: 99%

Home-care clients’ need for help, and use and costs of services

2008

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The aims of the study were to describe (1) the need for help as well as the use and costs of services of home help and/or home nursing (home care) and (2) to identify the variables associated with the use and costs of health and social care services. A total of 721 Finnish home-care clients were interviewed in 2001. The need for help was assessed by basic and instrumental activities of daily Living (ADL) and in terms of pain and illness, rest and sleep, psychosocial well-being and social and environment variables. The Anderson-Newman model was used to study predictors of use of services, including visits of home-care personnel and visits to the doctor, nurse, physiotherapist, laboratory and hospital. Weekly costs of services were calculated. Data were analyzed using multivariate analyses. The clients had poor functional ability and they needed help at least once a week with, on average, 6 out of 15 ADL functions, and 5 out of 13 items relating to pain and illnesses, rest and sleep, psychosocial well-being and social and environment items. The enabling and need variables, particularly the variables ''living alone'' and ''perceived need for help'', were important predictors for the use of services. Social care constituted more than half of the average weekly costs of municipalities. The perceived need for help with basic ADL was associated with higher costs. To ensure the quality of life among home-care clients while keeping costs reasonable is a challenge for municipalities.

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Section: Introductionmentioning

confidence: 99%

Home-care clients’ need for help, and use and costs of services

2008

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“…[7][8][9] For these patients, we collected from the outpatient medical record the number of PCP telephone contacts over the first 7 days following discharge. We ascertained time from index hospitalization until death from the Social Security Death Index (SSDI).…”

Section: Data Collection and Measuresmentioning

confidence: 99%

Rehospitalization of Older Adults Discharged to Home Hospice Care

Goldenheim

Oates

Parker

et al. 2014

Journal of Palliative Medicine

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Background: Acute hospital readmission of older adults receiving hospice care is not aligned with hospice goals. Objective: To identify factors associated with 30-day readmission among older adults newly discharged to hospice. Design/Subjects: Medical record review of 59 patients, 19 readmitted within 30 days and 40 randomly selected controls not readmitted, from 206 patients newly discharged to home hospice care between February 1, 2005 and January 31, 2010. Measures/Analysis: Information was collected about hospital course, end-of-life planning, and posthospitalization follow-up. We calculated bivariate associations and developed a Cox Proportional Hazards model examining the relation between index admission characteristics and readmission. Results: Patients' mean age was 79.7 -8.4; 74.6% were female; 52.5% were black. Among those readmitted, 25% had received a palliative care consultation, compared to 47.1% of those not readmitted ( p = 0.06). Patients without a participating decision-maker involved in their hospice decision had 3.5 times the risk of readmission within 30 days, compared to those with (hazard ratio [HR] 3.53, confidence interval [CI] 0.97, 12.82). Patients who had one or more telephone contacts with their primary care physician (PCP) during week 1 after discharge had 2.4 times the readmission risk within 30 days, compared to patients with no such contacts during this period (HR 2.35, CI 0.9, 6.1). Conclusions: Readmission within 30 days of initial discharge to hospice is associated with several measures of care and care planning. Further study of these measures may identify opportunities for interventions to improve the hospital-to-hospice transition and to decrease hospital readmissions.

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“…Chang et al [9] Descriptive, Retrospective (Level VI) [29] Observational Pilot (Level VI) 118 PTs from a RCT were evaluated for progress of study. Intervention involved implementation of care management program for "at-risk" older adults.…”

Section: Xmentioning

confidence: 99%

“…No differences in unplanned readmissions were noted. The second study [9] , a retrospective, descriptive study, analyzed 14-day readmission and risk factor data for patients who were visited by a discharge planning coordinator during hospitalization. The 14-day unplanned readmission rate was significantly greater for patients visited by social workers, home-care nurses, and hospice home-care nurses (p < .05) versus other types of health care providers (e.g., physical therapists, nutritionists, and diabetes education specialists).…”

Section: Intervention During Hospitalizationmentioning

confidence: 99%

Facilitating safe patient transition of care: A qualitative systematic review

Puls

Guerrero

Andrew

2014

JNEP

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Background: Failure to appropriately plan for a safe and effective transition to the next level of care leads to greater use of hospital and emergency services, often measured by rates of readmission. Despite a focus to develop programs to reduce readmissions, the 30-day all-cause readmission rate for Medicare patients in 2011 remained essentially unchanged. Purpose:The objective of this qualitative systematic review was to synthesize the evidence for interventions aimed at reducing readmissions through a transition of care program. Methods:We searched PubMed and Medline (OVID) with search terms including home care services, continuity of patient care, patient discharge, patient-centered care, health planning, and patient readmission. Selection criteria included quantitative studies, qualitative studies, and expert opinion articles in which a transition of care intervention, was implemented. The outcome of interest was readmission rates.Results: Thirty-three articles met inclusion criteria. The data were synthesized into two categories: primary studies in which the readmission rate was measured as an outcome, and studies that systematically reviewed interventions aimed at improving the discharge process. In all studies reviewed, a transitional care intervention resulted in a statistically significant reduction in readmission rate, or a rate trending lower, or the rate remained the same. Several studies evaluating an intervention occurring during and after hospitalization demonstrated significant results. Conclusion:There is value in reconfiguring discharge processes toward interventions that are more likely to reduce readmissions. The discharge process should incorporate a multidisciplinary, multicomponent transition of care intervention that involves hospital and home-care follow-up.

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Risks for unplanned hospital readmission in a teaching hospital in southern Taiwan

Cited by 8 publications

References 22 publications

Home-care clients’ need for help, and use and costs of services

Home-care clients’ need for help, and use and costs of services

Rehospitalization of Older Adults Discharged to Home Hospice Care

Facilitating safe patient transition of care: A qualitative systematic review

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