Can municipality-based post-discharge follow-up visits including a general practitioner reduce early readmission among the fragile elderly (65+ years old)? A randomized controlled trial
Thygesen, LC; Fokdal, S; Gjørup, T; et al.Taylor, RS; Zwisler, A-D; Prevention of Early Readmission Research Group
Date: 10 June 2015
Article
Journal
Scandinavian Journal of Primary Health Care
Publisher
Taylor & Francis
Publisher DOI
Related links
Abstract
OBJECTIVE: To evaluate how municipality-based post-discharge follow-up visits including a general practitioner and municipal nurse affect early readmission among high-risk older people discharged from a hospital department of internal medicine. DESIGN AND SETTING: Centrally randomized single-centre pragmatic controlled trial comparing ...
OBJECTIVE: To evaluate how municipality-based post-discharge follow-up visits including a general practitioner and municipal nurse affect early readmission among high-risk older people discharged from a hospital department of internal medicine. DESIGN AND SETTING: Centrally randomized single-centre pragmatic controlled trial comparing intervention and usual care with investigator-blinded outcome assessment. INTERVENTION: The intervention was home visits with a general practitioner and municipal nurse within seven days of discharge focusing on medication, rehabilitation plan, functional level, and need for further health care initiatives. The visit was concluded by planning one or two further visits. Controls received standard health care services. PATIENTS: People aged 65 + years discharged from Holbæk University Hospital, Denmark, in 2012 considered at high risk of readmission. MAIN OUTCOME MEASURES: The primary outcome was readmission within 30 days. Secondary outcomes at 30 and 180 days included readmission, primary health care, and municipal services. Outcomes were register-based and analysis used the intention-to-treat principle. RESULTS: A total of 270 and 261 patients were randomized to intervention and control groups, respectively. The groups were similar in baseline characteristics. In all 149 planned discharge follow-up visits were carried out (55%). Within 30 days, 24% of the intervention group and 23% of the control group were readmitted (p = 0.93). No significant differences were found for any other secondary outcomes except that the intervention group received more municipal nursing services. CONCLUSION: This municipality-based follow-up intervention was only feasible in half the planned visits. The intervention as delivered had no effect on readmission or subsequent use of primary or secondary health care services.
Institute of Health Research
Collections of Former Colleges
Item views 0
Full item downloads 0
Related items
Showing items related by title, author, creator and subject.
-
The GP Patient Survey for use in primary care in the National Health Service in the UK--development and psychometric characteristics
Campbell, John; Smith, P; Nissen, S; et al. (BioMed Central, 22 August 2009)BACKGROUND: The UK National GP Patient Survey is one of the largest ever survey programmes of patients registered to receive primary health care, inviting five million respondents to report their experience of NHS primary ... -
How do adults with physical disability experience primary care? A nationwide cross-sectional survey of access among patients in England
Popplewell, NTA; Rechel, BPD; Abel, GA (BMJ Publishing Group, 1 January 2014)Objectives: Almost a quarter of adults in England report a longstanding condition limiting physical activities. However, recent overseas evidence suggests poorer access to healthcare for disabled people. This study aimed ... -
'Talking a different language': an exploration of the influence of organizational cultures and working practices on transition from child to adult mental health services.
McLaren, S; Belling, R; Paul, M; et al. (BioMed Central, 3 July 2013)BACKGROUND: Organizational culture is manifest in patterns of behaviour underpinned by beliefs, values, attitudes and assumptions, which can influence working practices. Cultural factors and working practices have been ...