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Postdischarge Care and Readmissions

 

作者: David Smith,   Morris Weinberger,   Barry Katz,   Patricia Moore,  

 

期刊: Medical Care  (OVID Available online 1988)
卷期: Volume 26, issue 7  

页码: 699-708

 

ISSN:0025-7079

 

年代: 1988

 

出版商: OVID

 

关键词: patient readmission;patient ambulatory care;hospitalization;appointments and schedules

 

数据来源: OVID

 

摘要:

A multifaceted intervention was hypothesized to increase postdischarge ambulatory contacts and to reduce nonelective readmissions. Patients (N=1,001) discharged from the general medicine service were stratified by risk for nonelective readmission and randomized to the control or intervention group. Intervention patients received phone calls from nurses, mailings of appointment reminders and lists of early warning signs, and prompt rescheduling of visit failures. Patients were followed for 6 months, and the results were computed in units per patient per month. The intervention group had 10.4% more total office contacts (0.53 vs 0.48, P=0.005) than the control group. Although the intervention group had 7.6% fewer nonelective readmission days (0.85 vs 0.92), this was not statistically significant (P=0.5). Patients in the intervention group at high risk (N=181) had 28.1% more office visits (0.73 vs 0.57, P<0.01) and 31.9% fewer nonelective readmission days (1.13 vs 1.66), but this was also not statistically significant (P=0.06). Thus, the intervention significantly increased postdischarge contacts, primarily in high-risk patients, but failed to reduce the incidence of nonelective readmission days significantly.

 

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