Abstract
Background: home visits and telephone calls are two often used approaches in transitional care but their differential effects are unknown. Objective: to examine the overall effects of a transitional care programme for discharged medical patients and the differential effects of telephone calls only. Design: randomised controlled trial. Setting: a regional hospital in Hong Kong. Participants: patients discharged from medical units fitting the inclusion criteria (n = 610) were randomly assigned to: control ('control', n = 210), home visits with calls ('home', n = 196) and calls only ('call', n = 204). Intervention: the home groups received alternative home visits and calls and the call groups calls only for 4 weeks. The control group received two placebo calls. The nurse case manager was supported by nursing students in delivering the interventions. Results: the home visit group (after 4 weeks 10.7%, after 12 weeks 21.4%) and the call group (11.8, 20.6%) had lower readmission rates than the control group (17.6, 25.7%). Significance differences were detected in intention-to-treat (ITT) analysis for the home and intervention group (home and call combined) at 4 weeks. In the per-protocol analysis (PPA) results, significant differences were found in all groups at 4 weeks. There was significant improvement in quality of life, self-efficacy and satisfaction in both ITT and PPA for the study groups. Conclusions: this study has found that bundled interventions involving both home visits and calls are more effective in reducing readmissions. Many of the transitional care programmes use all-qualified nurses, and this study reveals that a mixed skills model seems to bring about positive effects as well.
Original language | English |
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Article number | aft123 |
Pages (from-to) | 91-97 |
Number of pages | 7 |
Journal | Age and Ageing |
Volume | 43 |
Issue number | 1 |
DOIs | |
Publication status | Published - 1 Jan 2014 |
Keywords
- Home visits
- Hospital readmissions
- Older people
- Telephone calls
- Transitional discharge support
ASJC Scopus subject areas
- Ageing
- Geriatrics and Gerontology