Effectiveness of home health care in reducing return to hospital: Evidence from a multi-hospital study in the US
| Autor: | Olga Yakusheva, Kathleen L. Bobay, James T. Bang, Danielle M. Siclovan, Jane M. Miles, Sarah J. Bahr, Linda L. Costa, Ronda G. Hughes, Marianne E. Weiss, Morris Hamilton |
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| Rok vydání: | 2020 |
| Předmět: |
Research design
medicine.medical_specialty Referral Aftercare Sample (statistics) Patient Readmission 03 medical and health sciences 0302 clinical medicine Home health Acute care Health care Medicine Humans 030212 general & internal medicine General Nursing Multinomial logistic regression 030504 nursing business.industry Emergency department Home Care Services Hospitals Patient Discharge United States Emergency medicine 0305 other medical science business Emergency Service Hospital |
| Zdroj: | International journal of nursing studies. 119 |
| ISSN: | 1873-491X |
| Popis: | Background Home health care, a commonly used bridge strategy for transitioning from hospital to home-based care, is expected to contribute to readmission avoidance efforts. However, in studies using disease-specific samples, evidence about the effectiveness of home health care in reducing readmissions is mixed. Objective To examine the effectiveness of home health care in reducing return to hospital across a diverse sample of patients discharged home following acute care hospitalization. Research design Secondary analysis of a multi-site dataset from a study of discharge readiness assessment and post-discharge return to hospital, comparing matched samples of patients referred and not referred for home health care at the time of hospital discharge. Setting Acute care, Magnet-designated hospitals in the United States Participants The available sample (n = 18,555) included hospitalized patients discharged from medical-surgical units who were referred (n = 3,579) and not referred (n = 14,976) to home health care. The matched sample included 2767 pairs of home health care and non- home health care patients matched on patient and hospitalization characteristics using exact and Mahalanobis distance matching. Methods Unadjusted t-tests and adjusted multinomial logit regression analyses to compare the occurrence of readmissions and Emergency Department/Observation visits within 30 and 60-days post-discharge. Results No statistically significant differences in readmissions or Emergency Department /Observation visits between home health care and non-home health care patients were observed. Conclusions Home health care referral was not associated with lower rates of return to hospital within 30 and 60 days in this US sample matched on patient and clinical condition characteristics. This result raises the question of why home health care services did not produce evidence of lower post-discharge return to hospital rates. Focused attention by home health care programs on strategies to reduce readmissions is needed. |
| Databáze: | OpenAIRE |
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