Teach-Back Experience and Hospitalization Risk Among Patients with Ambulatory Care Sensitive Conditions: a Matched Cohort Study.

Autor: Hong YR; Department of Health Services Research, Management and Policy in the College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA. youngrock.h@phhp.ufl.edu., Cardel M; Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA., Suk R; Department of Management, Policy and Community Health, The University of Texas Health Science Center, Houston, TX, USA., Vaughn IA; Center for Evaluation and Applied Research, The New York Academy of Medicine, New York, NY, USA., Deshmukh AA; Department of Management, Policy and Community Health, The University of Texas Health Science Center, Houston, TX, USA., Fisher CL; Department of Advertising, College of Journalism and Communications, University of Florida, Gainesville, FL, USA.; UF Health Cancer Center, Center for Arts in Medicine, STEM Translational Communication Center, University of Florida, Gainesville, FL, USA., Pavela G; Department of Health Behavior, School of Public Health University of Alabama, Birmingham, AL, USA., Sonawane K; Department of Management, Policy and Community Health, The University of Texas Health Science Center, Houston, TX, USA.
Jazyk: angličtina
Zdroj: Journal of general internal medicine [J Gen Intern Med] 2019 Oct; Vol. 34 (10), pp. 2176-2184. Date of Electronic Publication: 2019 Aug 05.
DOI: 10.1007/s11606-019-05135-y
Abstrakt: Background: The teach-back method, also known as the "show-me" method, has been endorsed by many medical and health care societies. However, limited investigation has been conducted regarding its association with patient outcomes.
Objectives: To examine the association between patient teach-back experience and the risk of hospitalizations and length of hospital stay among patients with ambulatory care sensitive conditions (ACSCs).
Design: A matched cohort study.
Setting: Data from the 2011-2015 Longitudinal Medical Expenditure Panel Survey (panels 16-19).
Participants: Three thousand nine hundred ninety-four US adults aged ≥ 18 years with any of 5 ACSCs (hypertension, type 2 diabetes, heart disease, asthma, and chronic obstructive pulmonary disease [COPD]).
Measurements: Hospital admissions (all-cause or ACSC-related) and the length of stay of the first admission were examined by teach-back during interaction with a health provider.
Results: Patients with teach-back experience were less likely to experience hospitalization for an ACSC-related condition (relative risk, 0.85; 95% CI, 0.71 to 0.99) and had a lower risk for a condition-related readmission (hazard ratio, 0.77; 95% CI, 0.60 to 0.99), compared with those without teach-back experience. The median length of hospital stay did not differ between patients with teach-back experience and those without teach-back experience (median 3 days [IQR 1 to 8 days] and median 3 days [IQR 0 to 8 days], respectively; P = 0.84). Subgroup analysis showed that the association of reported teach-back experience on the outcomes was relatively stable among those with hypertension, diabetes, and heart disease, but was not among those with asthma or COPD.
Limitation: Teach-back exposure relied on patient self-reported information.
Conclusions: Our findings suggest that patient teach-back method is associated with reduced risk of hospitalization for those with ACSCs, especially among patients with cardiovascular diseases and type 2 diabetes. Encouraging providers to utilize the teach-back method at every visit has the potential to further reduce hospitalizations for individuals with ACSCs.
Databáze: MEDLINE
Externí odkaz: