eCite Digital Repository

Transitional care interventions reduce unplanned hospital readmissions in high-risk older adults

Citation

Finlayson, K and Chang, AM and Courtney, MD and Edwards, HE and Parker, AW and Hamilton, K and Pham, TDX and O'Brien, J, Transitional care interventions reduce unplanned hospital readmissions in high-risk older adults, Bmc Health Services Research, 18, (1) Article 956. ISSN 1472-6963 (2018) [Refereed Article]


Preview
PDF
902Kb
  

Copyright Statement

Copyright 2018 The Authors. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0) https://creativecommons.org/licenses/by/4.0/

DOI: doi:10.1186/s12913-018-3771-9

Abstract

Background: Acute hospital services account for the largest proportion of health care system budgets, and older adults are the most frequent users. As a result, older people who have been recently discharged from hospital may be at greater risk of readmission. This study aims to evaluate the comparative effectiveness of transitional care interventions on unplanned hospital readmissions within 28 days, 12 weeks and 24 weeks following hospital discharge.

Method: The present study was a randomised controlled trial (ACTRN12608000202369). The trial involved 222 participants who were recruited from medical wards in two metropolitan hospitals in Australia. Participants were eligible for inclusion if they were aged 65 years and over, admitted with a medical diagnosis and had at least one risk factor for readmission. Participants were randomised to one of four groups: standard care, exercise program only, Nurse Home visit and Telephone follow-up (N-HaT), or Exercise program and Nurse Home visit and Telephone follow-up (ExN-HaT). Socio-demographics, health and functional ability were assessed at baseline, 28 days, 12 weeks and 24 weeks. The primary outcome measure was unplanned hospital readmission which was defined as any hospital admission for an unforeseen or unplanned cause.

Results: Participants in the ExN-HaT or the N-HaT groups were 3.6 times and 2.6 times respectively significantly less likely to have an unplanned readmission 28 days following discharge (ExN-HaT group HR 0.28, 95% CI 0.090.87, p = 0.029; N-HaT group HR 0.38, 95% CI 0.131.07, p = 0.067). Participants in the ExN-HaT or the N-HaT groups were 2.13 and 2.63 times respectively less likely to have an unplanned readmission in the 12 weeks after discharge (ExN-HaT group HR 0.47, 95% CI 0. 230.97, p = 0.014; N-HaT group HR 0.38, 95% CI 0.180.82, p = 0.040). At 24 weeks after discharge, there were no significant differences between groups.

Conclusion: Multifaceted transitional care interventions across hospital and community settings are beneficial, with lower hospital readmission rates observed in those receiving more transitional intervention components, although only in first 12 weeks.

Item Details

Item Type:Refereed Article
Keywords:hospital readmission, older adults, randomised controlled trial, transitional care
Research Division:Medical and Health Sciences
Research Group:Human Movement and Sports Science
Research Field:Exercise Physiology
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Diabetes
UTAS Author:O'Brien, J (Dr Jane O'Brien)
ID Code:129699
Year Published:2018
Deposited By:Health Sciences
Deposited On:2018-12-13
Last Modified:2019-03-25
Downloads:7 View Download Statistics

Repository Staff Only: item control page