Transitional Care Interventions Reduce Emergency Hospital Readmissions in Older Adults

2.50
Hdl Handle:
http://hdl.handle.net/10755/303996
Category:
Abstract
Type:
Presentation
Title:
Transitional Care Interventions Reduce Emergency Hospital Readmissions in Older Adults
Author(s):
Courtney, Mary; Finlayson, Kathleen; Chang, Anne M.; Parker, Anthony; Edwards, Helen Ethel
Lead Author STTI Affiliation:
Phi Delta
Author Details:
Mary Courtney, PhD, MHP, BAdmin (Acc), RN, Mary.Courtney@acu.edu.au; Kathleen Finlayson, PhD, MN, BN; Anne M. Chang, PhD, MEdSt, BEdSt, DipNEd, RN; Anthony Parker, PhD, MS, BS; Helen Ethel Edwards, OAM, PhD, BA (Hons), BA, DipApSc, RN;
Abstract:

Session presented on: Monday, July 22, 2013

Purpose:
Older adults account for the majority of hospital admissions, often experience multiple co-morbid conditions and have higher rates of emergency hospital readmissions than the general population. The purpose of this study was to conduct a randomised controlled trial to evaluate the relative effectiveness of transitional care interventions for community-based older adults on emergency hospital readmissions in the 28 days following discharge.

Methods:
A sample of 222 patients aged 65 years or older, with at least one known risk factor for hospital readmission, was recruited from medical wards in two metropolitan hospitals in Australia. Participants were randomised to either: usual care; an exercise intervention; a nurse in-home and telephone follow-up intervention; or a combined exercise and nursing follow-up intervention. Data were collected from participant surveys and hospital records.

Results:
The average age of participants was 78 years (SD 6.64). They were most frequently admitted with respiratory disease (38%) or cardiac disease (23%), and had a median of four co-morbidities.  In the first 28 days following discharge, 15.3% (n=31) of participants had an emergency readmission, 25% in the control group, and 14%, 12% and 9% in the exercise intervention, nurse intervention and combined intervention groups respectively. A Cox proportional hazards regression model found that the group receiving the combined interventions were 3.4 times (95% CI 1.15–10.1) less likely to experience an emergency readmission in comparison to the control group (p=0.03). Other significant predictors of emergency readmissions were increasing age, renal disease, depression and lower levels of chronic disease self efficacy.

Conclusion:
A multifaceted transitional care intervention for older adults at known risk of readmissions can halve the number of emergency readmissions. Implementation of this strategy is likely to improve health and decrease costs to the health care system.

Keywords:
transitional care; older adults; emergency readmissions
Repository Posting Date:
22-Oct-2013
Date of Publication:
22-Oct-2013
Conference Date:
2013
Conference Name:
24th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Prague, Czech Republic
Description:
24th International Nursing Research Congress Theme: Bridge the Gap Between Research and Practice Through Collaboration. Held at the Hilton Prague Hotel.
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleTransitional Care Interventions Reduce Emergency Hospital Readmissions in Older Adultsen_GB
dc.contributor.authorCourtney, Maryen_GB
dc.contributor.authorFinlayson, Kathleenen_GB
dc.contributor.authorChang, Anne M.en_GB
dc.contributor.authorParker, Anthonyen_GB
dc.contributor.authorEdwards, Helen Ethelen_GB
dc.contributor.departmentPhi Deltaen_GB
dc.author.detailsMary Courtney, PhD, MHP, BAdmin (Acc), RN, Mary.Courtney@acu.edu.au; Kathleen Finlayson, PhD, MN, BN; Anne M. Chang, PhD, MEdSt, BEdSt, DipNEd, RN; Anthony Parker, PhD, MS, BS; Helen Ethel Edwards, OAM, PhD, BA (Hons), BA, DipApSc, RN;en_GB
dc.identifier.urihttp://hdl.handle.net/10755/303996-
dc.description.abstract<p>Session presented on: Monday, July 22, 2013</p><b>Purpose: </b><br /="/">Older adults account for the majority of hospital admissions, often experience multiple co-morbid conditions and have higher rates of emergency hospital readmissions than the general population. The purpose of this study was to conduct a randomised controlled trial to evaluate the relative effectiveness of transitional care interventions for community-based older adults on emergency hospital readmissions in the 28 days following discharge. <p><b>Methods: </b><br /="/">A sample of 222 patients aged 65 years or older, with at least one known risk factor for hospital readmission, was recruited from medical wards in two metropolitan hospitals in Australia. Participants were randomised to either: usual care; an exercise intervention; a nurse in-home and telephone follow-up intervention; or a combined exercise and nursing follow-up intervention. Data were collected from participant surveys and hospital records. <p><b>Results: </b><br /="/">The average age of participants was 78 years (SD 6.64). They were most frequently admitted with respiratory disease (38%) or cardiac disease (23%), and had a median of four co-morbidities.  In the first 28 days following discharge, 15.3% (n=31) of participants had an emergency readmission, 25% in the control group, and 14%, 12% and 9% in the exercise intervention, nurse intervention and combined intervention groups respectively. A Cox proportional hazards regression model found that the group receiving the combined interventions were 3.4 times (95% CI 1.15–10.1) less likely to experience an emergency readmission in comparison to the control group (p=0.03). Other significant predictors of emergency readmissions were increasing age, renal disease, depression and lower levels of chronic disease self efficacy. <p><b>Conclusion: </b><br /="/">A multifaceted transitional care intervention for older adults at known risk of readmissions can halve the number of emergency readmissions. Implementation of this strategy is likely to improve health and decrease costs to the health care system.en_GB
dc.subjecttransitional careen_GB
dc.subjectolder adultsen_GB
dc.subjectemergency readmissionsen_GB
dc.date.available2013-10-22T20:27:18Z-
dc.date.issued2013-10-22-
dc.date.accessioned2013-10-22T20:27:18Z-
dc.conference.date2013en_GB
dc.conference.name24th International Nursing Research Congressen_GB
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen_GB
dc.conference.locationPrague, Czech Republicen_GB
dc.description24th International Nursing Research Congress Theme: Bridge the Gap Between Research and Practice Through Collaboration. Held at the Hilton Prague Hotel.en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.en_GB
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