Impact of Program Changes Including Telemedicine and Telephonic Care During the COVID-19 Pandemic in Preventing 30-Day Hospital Readmission for Patients in a Care Transitions Program.

Autor:	Takahashi PY; Mayo Clinic, Rochester, MN, USA., Thorsteinsdottir B; Mayo Clinic, Rochester, MN, USA., McCoy RG; Mayo Clinic, Rochester, MN, USA.; University of Maryland School of Medicine, Baltimore, MD.; University of Maryland Institute for Health Computing, Bethesda, MD, USA., Ramar P; Mayo Clinic, Rochester, MN, USA., Canning RE; Mayo Clinic, Rochester, MN, USA., Hanson GJ; Mayo Clinic, Rochester, MN, USA., Baumbach LJ; Mayo Clinic, Rochester, MN, USA., Chandra A; Mayo Clinic, Rochester, MN, USA., Philpot LM; Mayo Clinic, Rochester, MN, USA.
Jazyk:	angličtina
Zdroj:	Journal of primary care & community health [J Prim Care Community Health] 2024 Jan-Dec; Vol. 15, pp. 21501319241226547.
DOI:	10.1177/21501319241226547
Abstrakt:	Introduction/objectives: To describe health outcomes of older adults enrolled in the Mayo Clinic Care Transitions (MCCT) program before and during the COVID-19 pandemic compared to unenrolled patients. Methods: We conducted a retrospective cohort study of adults (age >60 years) in the MCCT program compared to a usual care control group from January 1, 2019, to September 20, 2022. The MCCT program involved a home, telephonic, or telemedicine visit by an advanced care provider. Outcomes were 30- and 180-day hospital readmissions, emergency department (ED) visit, and mortality. We performed a subgroup analysis after March 1, 2020 (during the pandemic). We analyzed data with Cox proportional hazards regression models and hazard ratios (HRs) with 95% CIs. Results: Of the 1,012 patients total, 354 were in the MCCT program and 658 were in the usual care group with a mean (SD) age of 81.1 (9.1) years overall. Thirty-day readmission was 16.9% (60 of 354) for MCCT patients and 14.7% (97 of 658) for usual care patients (HR, 1.24; 95% CI, 0.88-1.75). During the pandemic, the 30-day readmission rate was 15.1% (28 of 186) for MCCT patients and 14.9% (68 of 455) for usual care patients (HR, 1.20; 95% CI, 0.75-1.91). There was no difference between groups for 180-day hospitalization, 30- or 180-day ED visit, and 30- or 180-day mortality. Conclusions: Numerous factors involving patients, providers, and health care delivery systems during the pandemic most likely contributed to these findings. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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