Can Palliative Home Care Reduce 30-Day Readmissions? Results of a Propensity Score Matched Cohort Study

被引：38

作者：

Ranganathan, Anjana ^{[1
]}

Dougherty, Meredith ^{[2
,3
,4
]}

Waite, David ^{[3
,4
]}

Casarett, David ^{[1
]}

机构：

[1] Univ Penn, Dept Med, Perelman Sch Med, Philadelphia, PA 19104 USA

[2] Univ Penn Hlth Syst, Philadelphia, PA USA

[3] Univ Penn, Penn Home Care Serv, Bala Cynwyd, PA USA

[4] Univ Penn, Hosp Serv, Bala Cynwyd, PA USA

来源：

JOURNAL OF PALLIATIVE MEDICINE | 2013年 / 16卷 / 10期

基金：

美国国家卫生研究院;

关键词：

RANDOMIZED-TRIAL; STRATEGIES; SELECTION; PROGRAM; RATES;

D O I：

10.1089/jpm.2013.0213

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Objective: This study examined the impact of palliative home nursing care on rates of hospital 30-day readmissions. Methods: The electronic health record based retrospective cohort study was performed within home care and palliative home care programs. Participants were home care patients discharged from one of three urban teaching hospitals. Outcome measures were propensity score matched rates of hospital readmissions within 30 days of hospital discharge. Results: Of 406 palliative home care patients, matches were identified for 392 (96%). Of 15,709 home care patients, 890 were used at least once as a match for palliative care patients, for a total final sample of 1282. Using the matched sample we calculated the average treatment effect for treated patients. In this sample, palliative care patients had a 30-day readmission probability of 9.1% compared to a probability of 17.4% in the home care group (mean ATT: 8.3%; 95% confidence interval [CI] 8.0%-8.6%). This effect persisted after adjustment for visit frequency. Conclusions: Palliative home care may offer benefits to health systems by allowing patients to remain at home and thereby avoiding 30-day rehospitalizations.

引用

页码：1290 / 1293

页数：4

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