Integrated postdischarge transitional care in a hospitalist system to improve discharge outcome: an experimental study
2011

Improving Patient Care After Hospital Discharge

Sample size: 313 publication 10 minutes Evidence: moderate

Author Information

Author(s): Shu Chin-Chung, Hsu Nin-Chieh, Lin Yu-Feng, Wang Jann-Yuan, Lin Jou-Wei, Ko Wen-Je

Primary Institution: National Taiwan University Hospital

Hypothesis

Can integrated postdischarge transitional care reduce readmission rates and mortality in patients discharged from a hospitalist system?

Conclusion

Integrated postdischarge transitional care can reduce rates of readmission and death within 30 days after discharge.

Supporting Evidence

  • Patients who received integrated transitional care had lower readmission rates than those who did not.
  • The intervention group had a 15% readmission rate compared to 25% in the control group.
  • Telephone monitoring identified patients at risk of readmission due to worsening symptoms.

Takeaway

This study shows that helping patients after they leave the hospital can keep them from coming back and help them stay healthy.

Methodology

Patients were divided into control and intervention groups, with the intervention group receiving integrated postdischarge transitional care including follow-up calls and a hotline.

Potential Biases

Potential bias from patients' or caregivers' incorrect statements during telephone monitoring.

Limitations

The study design was not randomized, and there was a considerable number of patients excluded which may bias the results.

Participant Demographics

Patients older than 18 years, admitted to the hospitalist ward, and discharged alive to home care.

Statistical Information

P-Value

0.021

Confidence Interval

95% CI 1.33 to 4.11

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1186/1741-7015-9-96

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