دورية أكاديمية
Management of Nursing Home Residents Following Acute Hospitalization: Efficacy of the "Regular Early Assessment Post-Discharge (REAP)" Intervention.
| العنوان: | Management of Nursing Home Residents Following Acute Hospitalization: Efficacy of the "Regular Early Assessment Post-Discharge (REAP)" Intervention. |
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| المؤلفون: | Cordato NJ; Department of Aged Care, St George Hospital, Kogarah, Australia; Calvary Health Care Sydney, Kogarah, Australia; Faculty of Medicine, University of New South Wales, Sydney, Australia. Electronic address: nicholas.cordato@health.nsw.gov.au., Kearns M; Department of Aged Care, St George Hospital, Kogarah, Australia., Smerdely P; Department of Aged Care, St George Hospital, Kogarah, Australia; Calvary Health Care Sydney, Kogarah, Australia; Faculty of Medicine, University of New South Wales, Sydney, Australia., Seeher KM; Faculty of Medicine, University of New South Wales, Sydney, Australia; Dementia Centre for Research Collaboration, University of New South Wales, Sydney, Australia; Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia., Gardiner MD; Calvary Health Care Sydney, Kogarah, Australia; Faculty of Medicine, University of New South Wales, Sydney, Australia., Brodaty H; Faculty of Medicine, University of New South Wales, Sydney, Australia; Dementia Centre for Research Collaboration, University of New South Wales, Sydney, Australia; Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia; Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, Australia. Electronic address: h.brodaty@unsw.edu.au. |
| المصدر: | Journal of the American Medical Directors Association [J Am Med Dir Assoc] 2018 Mar; Vol. 19 (3), pp. 276.e11-276.e19. Date of Electronic Publication: 2018 Feb 01. |
| نوع المنشور: | Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 100893243 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1538-9375 (Electronic) Linking ISSN: 15258610 NLM ISO Abbreviation: J Am Med Dir Assoc Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2005- : [New York?] : Elsevier Original Publication: Hagerstown, MD : Lippincott Williams & Wilkins, c2000- |
| مواضيع طبية MeSH: | Emergency Service, Hospital/*statistics & numerical data , Geriatric Assessment/*methods , Hospitalization/*economics , Hospitalization/*statistics & numerical data , Nursing Assessment/*methods , Nursing Homes/*organization & administration , Patient Discharge/*statistics & numerical data , Patient Readmission/*statistics & numerical data, Aged ; Australia ; Cost-Benefit Analysis ; Female ; Humans ; Length of Stay/statistics & numerical data ; Male ; Prospective Studies |
| مستخلص: | Objectives: Rehospitalization of nursing home (NH) residents is frequent, costly, potentially avoidable and associated with diminished quality of life and poor survival. This study aims to evaluate the impact and cost-effectiveness of the Regular Early Assessment Post-Discharge (REAP) protocol of coordinated specialist geriatrician and nurse practitioner visits on rates of rehospitalization, hospital length of stay, and emergency department presentations for NH residents recently discharged from hospital. Design: Prospective randomized controlled study of recently hospitalized NH residents. Setting: Twenty-one of 24 eligible NHs within the geographical catchment area of St George Hospital, a 650-bed university hospital in Sydney, Australia. Participants: NH residents from eligible facilities admitted to St George Hospital's geriatric service were enrolled prior to hospital discharge. Intervention: REAP intervention of monthly coordinated specialist geriatrician and nurse practitioner assessments within participants' NHs for 6 months following hospital discharge. Measurements: Impact of the REAP intervention on hospital readmissions, hospital inpatient days, emergency department utilization, general practitioner visits, investigations and associated costs during the study intervention period. Results: Forty-three NH residents were randomly allocated to REAP intervention (n = 22) or control (n = 21) groups. The REAP intervention group had almost two-thirds fewer hospital readmissions (P = .03; Cohen's d = 0.73) and half as many emergency department visits than controls. Total costs were 50% lower in the REAP intervention group, with lower total hospital inpatient (P = .04; Cohen's d = 0.63) and total emergency department (P = .04; Cohen's d = 0.65) costs. Conclusion: Cost-effective reductions in the utilization of hospital-related services were demonstrated following implementation of the REAP intervention for NH residents recently discharged from hospital. (Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Geriatrics; costs; follow-up; nursing home; rehospitalization |
| تواريخ الأحداث: | Date Created: 20180204 Date Completed: 20191112 Latest Revision: 20191112 |
| رمز التحديث: | 20240829 |
| DOI: | 10.1016/j.jamda.2017.12.008 |
| PMID: | 29396192 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1538-9375 |
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| DOI: | 10.1016/j.jamda.2017.12.008 |