Unplanned Hospital Readmissions: A Home Care Perspective

Abstract

Chronic illness appears to be the best indicator for hospital readmission. The crucial time period for hospital readmission during home care is the first 2-3 weeks following hospital discharge. Intensive study of home care service arrangements utilized by readmitted patients, as well as agency variations, are needed. Study findings concerning patients readmitted from home care point to similarities with rehospitalized patients generally. Findings may assist home care clinicians in targeting high risk patients who could benefit from interventions aimed at minimizing unplanned returns to the hospital.

The Impact of Postdischarge Telephonic Follow-Up on Hospital Readmissions

“…16 This problem is further exacerbated by increasing prevalence and severity of chronic disease, 17 which is the greatest indicator of readmission. 13 For these two reasons, a hospital discharge call campaign was developed specifically for individuals with chronic conditions. Among all members of the health plan in this study who were hospitalized in 2008, the data clearly show that male sex, older age, and greater initial LOS are associated with an increased likelihood of readmission.…”

“…The 14-day requirement was imposed because the first 2-3 weeks after discharge are considered the critical window for prevention of readmissions. 13 The exceptions were members who were readmitted prior to receiving a discharge call; these members, who comprised only 0.5% of the total study population, were assigned to the comparison group because a discharge call must precede a readmission to have the opportunity to prevent that readmission. Members who did not receive a discharge call within 30 days of initial hospital discharge and those members who received discharge calls between days 15 and 30 following their initial hospital discharge were also assigned to the comparison group.…”

The effect of a tailored message intervention on heart failure readmission rates, quality of life, and benefit and barrier beliefs in persons with heart failure

“…Prior research suggests that readmission may occur because of difficulty adjusting to medication changes. 8 The final follow-up visit took place 1 month after discharge in the subject's home, and the same research nurse again visited the subject. Quality of life scores were determined at the final interview, and medications were reviewed for any changes.…”

“…The times selected for study correspond with times identified in the literature as the period of greatest risk for rehospitalization in elderly patients. 8,27,28 The following research questions are the basis for the study:…”

Reingreso hospitalario en Medicina Interna

“…En algunos procesos clínicos con alta tasa de reingreso una intervención basada en unidades de enfermería reducen la tasa de reingreso y mejoran la calidad de vida (41,46). También la accesibilidad y rapidez de consulta externa puede influenciar la reducción de reingresos (42), aunque en algunos estudios la accesibilidad a atención primaria tuvo un efecto adverso sobre la tasa de reingreso hospitalario (43) y el control en la consulta externa tras el alta tampoco redundó en reducir dicha tasa (44). Se ha estipulado que el control en consulta externa 2-3 semanas tras el alta hospitalaria es el tiempo ideal para reducir el reingreso (45).…”