Clinical Effectiveness, Access to, and Satisfaction with Care Using a Telehomecare Substitution Intervention: A Randomized Controlled Trial
Autor: | Kathryn H. Bowles, Alexandra L. Hanlon, Henry A. Glick, Mary D. Naylor, Melissa O'Connor, Barbara Riegel, Nai-Wei Shih, Mark G. Weiner |
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Jazyk: | angličtina |
Rok vydání: | 2011 |
Předmět: | |
Zdroj: | International Journal of Telemedicine and Applications, Vol 2011 (2011) |
Druh dokumentu: | article |
ISSN: | 1687-6415 1687-6423 |
DOI: | 10.1155/2011/540138 |
Popis: | Background. Hospitalization accounts for 70% of heart failure (HF) costs; readmission rates at 30 days are 24% and rise to 50% by 90 days. Agencies anticipate that telehomecare will provide the close monitoring necessary to prevent HF readmissions. Methods and Results. Randomized controlled trial to compare a telehomecare intervention for patients 55 and older following hospital discharge for HF to usual skilled home care. Primary endpoints were 30- and 60-day all-cause and HF readmission, hospital days, and time to readmission or death. Secondary outcomes were access to care, emergency department (ED) use, and satisfaction with care. All-cause readmissions at 30 days (16% versus 19%) and over six months (46% versus 52%) were lower in the telehomecare group but were not statistically significant. Access to care and satisfaction were significantly higher for the telehomecare patients, including the number of in-person visits and days in home care. Conclusions. Patient acceptance of the technology and current home care policies and processes of care were barriers to gaining clinical effectiveness and efficiency. |
Databáze: | Directory of Open Access Journals |
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