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ABSTRACT: Background
home visits and telephone calls are two often used approaches in transitional care but their differential effects are unknown.Objective
to examine the overall effects of a transitional care programme for discharged medical patients and the differential effects of telephone calls only.Design
randomised controlled trial.Setting
a regional hospital in Hong Kong.Participants
patients discharged from medical units fitting the inclusion criteria (n = 610) were randomly assigned to: control ('control', n = 210), home visits with calls ('home', n = 196) and calls only ('call', n = 204).Intervention
the home groups received alternative home visits and calls and the call groups calls only for 4 weeks. The control group received two placebo calls. The nurse case manager was supported by nursing students in delivering the interventions.Results
the home visit group (after 4 weeks 10.7%, after 12 weeks 21.4%) and the call group (11.8, 20.6%) had lower readmission rates than the control group (17.6, 25.7%). Significance differences were detected in intention-to-treat (ITT) analysis for the home and intervention group (home and call combined) at 4 weeks. In the per-protocol analysis (PPA) results, significant differences were found in all groups at 4 weeks. There was significant improvement in quality of life, self-efficacy and satisfaction in both ITT and PPA for the study groups.Conclusions
this study has found that bundled interventions involving both home visits and calls are more effective in reducing readmissions. Many of the transitional care programmes use all-qualified nurses, and this study reveals that a mixed skills model seems to bring about positive effects as well.
SUBMITTER: Wong FK
PROVIDER: S-EPMC3861338 | biostudies-literature | 2014 Jan
REPOSITORIES: biostudies-literature
Age and ageing 20130826 1
<h4>Background</h4>home visits and telephone calls are two often used approaches in transitional care but their differential effects are unknown.<h4>Objective</h4>to examine the overall effects of a transitional care programme for discharged medical patients and the differential effects of telephone calls only.<h4>Design</h4>randomised controlled trial.<h4>Setting</h4>a regional hospital in Hong Kong.<h4>Participants</h4>patients discharged from medical units fitting the inclusion criteria (n = ...[more]