Effects of Different Transitional Care Strategies on Outcomes after Hospital Discharge-Trust Matters, Too
Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved..
BACKGROUND: As health systems shift toward value-based care, strategies to reduce readmissions and improve patient outcomes become increasingly important. Despite extensive research, the combinations of transitional care (TC) strategies associated with best patient-centered outcomes remain uncertain.
METHODS: Using an observational, prospective cohort study design, Project ACHIEVE sought to determine the association of different combinations of TC strategies with patient-reported and postdischarge health care utilization outcomes. Using purposive sampling, the research team recruited a diverse sample of short-term acute care and critical access hospitals in the United States (N = 42) and analyzed data on eligible Medicare beneficiaries (N = 7,939) discharged from their medical/surgical units. Using both hospital- and patient-reported TC strategy exposure data, the project compared patients "exposed" to each of five overlapping groups of TC strategies to their "control" counterparts. Primary outcomes included 30-day hospital readmissions, 7-day postdischarge emergency department (ED) visits and patient-reported physical and mental health, pain, and participation in daily activities.
RESULTS: Participants averaged 72.3 years old (standard deviation =10.1), 53.4% were female, and most were White (78.9%). Patients exposed to one TC group (Hospital-Based Trust, Plain Language, and Coordination) were less likely to have 30-day readmissions (risk ratio [RR], 0.72; 95% confidence interval [CI] = 0.57-0.92, p < 0.001) or 7-day ED visits (RR, 0.72; 95% CI, 0.55-0.93, p < 0.001) and more likely to report excellent physical and mental health, greater participation in daily activities, and less pain (RR ranged from 1.11 to 1.15, p < 0.01).
CONCLUSION: In concert with care coordination activities that bridge the transition from hospital to home, hospitals' clear communication and fostering of trust with patients were associated with better patient-reported outcomes and reduced health care utilization.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:48 |
|---|---|
| Enthalten in: |
Joint Commission journal on quality and patient safety - 48(2022), 1 vom: 08. Jan., Seite 40-52 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Li, Jing [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Care transitions |
|---|
| Anmerkungen: |
Date Completed 04.04.2022 Date Revised 05.04.2022 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.jcjq.2021.09.012 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM333019180 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM333019180 | ||
| 003 | DE-627 | ||
| 005 | 20231225220756.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.jcjq.2021.09.012 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1110.xml |
| 035 | |a (DE-627)NLM333019180 | ||
| 035 | |a (NLM)34764025 | ||
| 035 | |a (PII)S1553-7250(21)00245-2 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Li, Jing |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Effects of Different Transitional Care Strategies on Outcomes after Hospital Discharge-Trust Matters, Too |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 04.04.2022 | ||
| 500 | |a Date Revised 05.04.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: As health systems shift toward value-based care, strategies to reduce readmissions and improve patient outcomes become increasingly important. Despite extensive research, the combinations of transitional care (TC) strategies associated with best patient-centered outcomes remain uncertain | ||
| 520 | |a METHODS: Using an observational, prospective cohort study design, Project ACHIEVE sought to determine the association of different combinations of TC strategies with patient-reported and postdischarge health care utilization outcomes. Using purposive sampling, the research team recruited a diverse sample of short-term acute care and critical access hospitals in the United States (N = 42) and analyzed data on eligible Medicare beneficiaries (N = 7,939) discharged from their medical/surgical units. Using both hospital- and patient-reported TC strategy exposure data, the project compared patients "exposed" to each of five overlapping groups of TC strategies to their "control" counterparts. Primary outcomes included 30-day hospital readmissions, 7-day postdischarge emergency department (ED) visits and patient-reported physical and mental health, pain, and participation in daily activities | ||
| 520 | |a RESULTS: Participants averaged 72.3 years old (standard deviation =10.1), 53.4% were female, and most were White (78.9%). Patients exposed to one TC group (Hospital-Based Trust, Plain Language, and Coordination) were less likely to have 30-day readmissions (risk ratio [RR], 0.72; 95% confidence interval [CI] = 0.57-0.92, p < 0.001) or 7-day ED visits (RR, 0.72; 95% CI, 0.55-0.93, p < 0.001) and more likely to report excellent physical and mental health, greater participation in daily activities, and less pain (RR ranged from 1.11 to 1.15, p < 0.01) | ||
| 520 | |a CONCLUSION: In concert with care coordination activities that bridge the transition from hospital to home, hospitals' clear communication and fostering of trust with patients were associated with better patient-reported outcomes and reduced health care utilization | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Care transitions | |
| 650 | 4 | |a Hospital Readmissions | |
| 650 | 4 | |a Patient Communication | |
| 650 | 4 | |a Trust | |
| 700 | 1 | |a Clouser, Jessica Miller |e verfasserin |4 aut | |
| 700 | 1 | |a Brock, Jane |e verfasserin |4 aut | |
| 700 | 1 | |a Davis, Terry |e verfasserin |4 aut | |
| 700 | 1 | |a Jack, Brian |e verfasserin |4 aut | |
| 700 | 1 | |a Levine, Carol |e verfasserin |4 aut | |
| 700 | 1 | |a Mays, Glen P |e verfasserin |4 aut | |
| 700 | 1 | |a Mittman, Brian |e verfasserin |4 aut | |
| 700 | 1 | |a Nguyen, Huong |e verfasserin |4 aut | |
| 700 | 1 | |a Sorra, Joann |e verfasserin |4 aut | |
| 700 | 1 | |a Stromberg, Arnold |e verfasserin |4 aut | |
| 700 | 1 | |a Du, Gaixin |e verfasserin |4 aut | |
| 700 | 1 | |a Dai, Chen |e verfasserin |4 aut | |
| 700 | 1 | |a Adu, Akosua |e verfasserin |4 aut | |
| 700 | 1 | |a Vundi, Nikita |e verfasserin |4 aut | |
| 700 | 1 | |a Williams, Mark V |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Joint Commission journal on quality and patient safety |d 2005 |g 48(2022), 1 vom: 08. Jan., Seite 40-52 |w (DE-627)NLM153492597 |x 1938-131X |7 nnns |
| 773 | 1 | 8 | |g volume:48 |g year:2022 |g number:1 |g day:08 |g month:01 |g pages:40-52 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.jcjq.2021.09.012 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 48 |j 2022 |e 1 |b 08 |c 01 |h 40-52 | ||