Clinical Interventions in Aging
Open access peer-reviewed scientific and medical journals.
Dove Medical Press is now a member of the Open Access Initiative
An Author's Guide
A guide to help authors get their paper published.
Support Open Access and Dove Press
Promotional Article Monitoring - further details
Favored Author Program
Real benefits for authors, including fast-track processing of papers.
30-day hospital readmission of older adults using care transitions after hospitalization: a pilot prospective cohort study
(2868) Total Article Views
Authors: Takahashi PY, Haas LR, Quigg SM, Croghan IT, Naessens JM, Shah ND, Hanson GJ
Published Date June 2013
Volume 2013:8 Pages 729 - 736
|Received:||22 February 2013|
|Accepted:||20 March 2013|
|Published:||18 June 2013|
1Division of Primary Care Internal Medicine, Department of Medicine, 2Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
Purpose: Patients leaving the hospital are at increased risk of functional decline and hospital readmission. The Employee and Community Health service at Mayo Clinic in Rochester developed a care transition program (CTP) to provide home-based care services for medically complex patients. The study objective was to determine the relationship between CTP use, 30-day hospital readmission, and Emergency Room (ER) visits for adults over 60 years with high Elder Risk Assessment scores.
Patients and methods: This was a pilot prospective cohort study that included 20 patients that used the CTP and 20 patients discharged from the hospital without using the CTP. The medically complex study patients were drawn from the department of Employee and Community Health population between October 14, 2011 and September 27, 2012. The primary outcomes were 30-day hospital readmission or ER visit after discharge from the hospital. The secondary outcomes were within-group changes in grip strength, gait speed, and quality of life (QOL). Patients underwent two study visits, one at baseline and one at 30 days postbaseline. The primary analysis included time-to-event from baseline to rehospitalization or ER visit. Paired t-tests were used for secondary outcomes, with continuous scores.
Results: Of the 40 patients enrolled, 36 completed all study visits. The 30-day hospital readmission rates for usual care patients were 10.5% compared with no readmissions for CTP patients. There were 31.6% ER visits in the UC group and 11.8% in the CTP group (P = 0.37). The secondary analysis showed some improvement in physical QOL scores (pre: 32.7; post: 39.4) for the CTP participants (P < 0.01) and no differences in gait speed or grip strength.
Conclusion: Based on this pilot study of care transition, we found nonsignificant lower hospital and ER utilization rates and improved physical QOL scores for patients in the CTP group. However, the data leads us to recommend future studies with larger sample sizes (N = 250).
Keywords: case management, cohort study, frailty, geriatrics
Cannotea Citeulike Del.icio.us Facebook LinkedIn Twitter
This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php
Other articles by Dr Paul Takahashi
Readers of this article also read:
- New eBook
Have a look at Dr Richard Walker's must read eBook on Amazon Kindle Why we age: Insight into the cause of growing old
- American Acne and Rosacea Society
The American Acne and Rosacea Society (AARS) is a 501(c)(6) non-profit organization dedicated to elevating the understanding and treatment of acne and rosacea.
- Have an opinion about one of our articles?
We encourage you to write a letter to the editor.
- 27th ECNP Congress
18 - 21 October, 2014
- Radio electric asymmetric brain stimulation in the treatment of behavioral and psychiatric symptoms in Alzheimer disease
- Eggshell membrane: A possible new natural therapeutic for joint and connective tissue disorders. Results from two open-label human clinical studies
- Comparison of two treatments for coxarthrosis: local hyperthermia versus radio electric asymmetrical brain stimulation
- The cognitive impact of anticholinergics: A clinical review