Implementation of discharge management for geriatric patients at risk of readmission or institutionalization
| Autor: | V. Tellier, Sabina De Geest, Christiane Gosset, Philip Moons, Ivo Abraham, Koen Milisen, Cécile De Froidmont, Nele De Bal, Els Steeman |
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| Rok vydání: | 2006 |
| Předmět: |
Male
medicine.medical_specialty Institutionalisation medicine.medical_treatment MEDLINE Gerontological nursing Hospitals General Patient Readmission Case mix index Belgium Geriatric Nursing Intervention (counseling) medicine Humans Aged Aged 80 and over Rehabilitation business.industry Health Policy Public Health Environmental and Occupational Health General Medicine Odds ratio medicine.disease Patient Discharge Discharge planning Emergency medicine Female Medical emergency Diffusion of Innovation business Case Management |
| Zdroj: | International journal for quality in health care : journal of the International Society for Quality in Health Care. 18(5) |
| ISSN: | 1353-4505 |
| Popis: | Objective. To evaluate whether implementation of discharge management by trained social workers or nurses reduces hospital readmissions and institutionalizations of geriatric patients in a real-world setting. Design. Quasi-experimental design. Setting. Six general hospitals in Belgium. Participants. A representative sample of 824 patients, 355 of whom were assigned to the experimental group receiving comprehensive discharge management and 469 to the control group receiving usual care. Inclusion criteria were patients admitted to a geriatric, rehabilitation, or internal medicine ward, not residing in a nursing home, and showing risk of readmission or institutionalization on admission in the hospital. Intervention. In-hospital discharge planning according to a case management protocol allowing for adjustment to participating hospitals’ case mix and patients’ and families’ specific needs. Main outcome measures. Hospital readmission within 15 and 90 days post discharge; institutionalization at discharge and within 15 and 90 days post discharge. Results. Discharge management resulted in fewer institutionalizations (n = 53; 14.9%) compared with usual care (n = 130; 23.7%) (adjusted odds ratio = 0.47; CI 95% = 0.31–0.70). Readmission rates between the intervention and usual care group were not significantly different. Conclusions. This implementation project showed that a discharge planning intervention can reduce institutionalization rates of elderly patients in real-life settings. |
| Databáze: | OpenAIRE |
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