Effect of the Hospital Elder Life Program on Risk of 30‐Day Readmission
| Autor: | Andrew Bilderback, Sharon K. Inouye, Kevin Urda, Johanna E. Bellon, Fred H. Rubin |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Comorbidity Lower risk Patient Readmission 01 natural sciences Article 03 medical and health sciences symbols.namesake Sex Factors 0302 clinical medicine Risk Factors Early Medical Intervention medicine Humans 030212 general & internal medicine Poisson regression 0101 mathematics Prospective cohort study Aged Retrospective Studies Aged 80 and over business.industry 010102 general mathematics Age Factors Delirium Retrospective cohort study Quality Improvement Confidence interval Hospitalization Relative risk Emergency medicine Cohort symbols Female Geriatrics and Gerontology medicine.symptom business |
| Zdroj: | Journal of the American Geriatrics Society. 66:145-149 |
| ISSN: | 1532-5415 0002-8614 |
| DOI: | 10.1111/jgs.15132 |
| Popis: | Objectives To compare rates of 30-day readmission between hospital units with a Hospital Elder Life Program (HELP) and control units without HELP. Design Retrospective cohort study. Setting The study took place from July 1, 2013, to June 30, 2014, at the University of Pittsburgh Medical Center Shadyside, a 520-bed community teaching hospital that has used HELP since 2002. Eight medical and surgical units with HELP were compared with 10 medical and surgical units without HELP. Participants During the study period, HELP units, had 4,794 patients aged 70 and older, and usual care units had 2,834. Intervention HELP is a multifactorial, multidisciplinary program that provides targeted interventions for delirium risk factors in at-risk individuals in collaboration with bedside staff. Measurements Mixed-effects Poisson regression models were used to estimate the adjusted incident risk ratio for 30-day readmission between HELP and usual care units for the overall cohort and for the subgroup of individuals discharged home, with or without services. Results Patients on HELP units were more likely than those in usual care units to be older, female, and black and had an unadjusted readmission rate of 16.9%, versus 18.9% for patients on control units. The adjusted risk of readmission was 0.83 (95% confidence interval (CI) = 0.73–0.94, P = .003) for HELP unit patients overall and 0.74 (95% CI = 0.63–0.87, P < .001) for HELP unit patients discharged to home with or without services. Conclusion The HELP program is associated with lower risk of 30-day hospital readmission overall and for the subgroup of individuals discharged to home. Prospective studies are needed to confirm these observations. |
| Databáze: | OpenAIRE |
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