Dataset Information

Reducing Readmissions among Heart Failure Patients Discharged to Home Health Care: Effectiveness of Early and Intensive Nursing Services and Early Physician Follow-Up.

ABSTRACT:

Objective

To compare the effectiveness of two "treatments"-early, intensive home health nursing and physician follow-up within a week-versus less intense and later postacute care in reducing readmissions among heart failure (HF) patients discharged to home health care.

Data sources

National Medicare administrative, claims, and patient assessment data.

Study design

Patients with a full week of potential exposure to the treatments were followed for 30 days to determine exposure status, 30-day all-cause hospital readmission, other health care use, and mortality. An extension of instrumental variables methods for nonlinear statistical models corrects for nonrandom selection of patients into treatment categories. Our instruments are the index hospital's rate of early aftercare for non-HF patients and hospital discharge day of the week.

Data extraction methods

All hospitalizations for a HF principal diagnosis with discharge to home health care between July 2009 and June 2010 were identified from source files.

Principal findings

Neither treatment by itself has a statistically significant effect on hospital readmission. In combination, however, they reduce the probability of readmission by roughly 8 percentage points (p < .001; confidence interval = -12.3, -4.1). Results are robust to changes in implementation of the nonlinear IV estimator, sample, outcome measure, and length of follow-up.

Conclusions

Our results call for closer coordination between home health and medical providers in the clinical management of HF patients immediately after hospital discharge.

SUBMITTER: Murtaugh CM

PROVIDER: S-EPMC5517672 | biostudies-literature | 2017 Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Reducing Readmissions among Heart Failure Patients Discharged to Home Health Care: Effectiveness of Early and Intensive Nursing Services and Early Physician Follow-Up.

Murtaugh Christopher M CM Deb Partha P Zhu Carolyn C Peng Timothy R TR Barrón Yolanda Y Shah Shivani S Moore Stanley M SM Bowles Kathryn H KH Kalman Jill J Feldman Penny H PH Siu Albert L AL

Health services research 20160728 4

<h4>Objective</h4>To compare the effectiveness of two "treatments"-early, intensive home health nursing and physician follow-up within a week-versus less intense and later postacute care in reducing readmissions among heart failure (HF) patients discharged to home health care.<h4>Data sources</h4>National Medicare administrative, claims, and patient assessment data.<h4>Study design</h4>Patients with a full week of potential exposure to the treatments were followed for 30 days to determine exposu ...[more]

PMID: 27468707

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Dataset Information

Reducing Readmissions among Heart Failure Patients Discharged to Home Health Care: Effectiveness of Early and Intensive Nursing Services and Early Physician Follow-Up.

Objective

Data sources

Study design

Data extraction methods

Principal findings

Conclusions

Publications

Reducing Readmissions among Heart Failure Patients Discharged to Home Health Care: Effectiveness of Early and Intensive Nursing Services and Early Physician Follow-Up.

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