Impact of a Social Work Care Coordination Intervention on Hospital Readmission: A Randomized Controlled Trial
Impact of a Social Work Care Coordination Intervention on Hospital Readmission: A Randomized Controlled Trial
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DOI：
10.1093/sw/swv016
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发表时间：
2015-07-01
期刊：
影响因子：
2.9
通讯作者：
Marks, Kris
中科院分区：
文献类型：
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作者：
Bronstein, Laura R.;Gould, Paul;Marks, Kris
这项研究评估了社会工作领导的护理协调干预如何降低50岁或以上的中高危患者30天内再次住院率。作者进行了一项随机对照试验，以确定出院后接受常规护理的患者和接受MSW实习生干预的患者(一次家访和一到两个电话)在30天内再次住院率是否存在显著差异。结果是使用花边指数评分为7或更高的住院患者样本(N=89)获得的。分析表明，干预将不再入院的可能性提高了约22%(RR=1.222；95%CI=1.063-1.405)。干预后的风险改善具有非常显著的统计学意义(p=0.003)。这项研究表明，由MSW实习生进行的时间效率高的护理协调干预可能会降低再次住院率。这项研究在人口更多样化、患者数量更多的其他社区重复进行，将表明结果是否可推广。
This study assessed how a social work-led care coordination intervention would reduce the within-30-day hospital readmission rate among moderate-and high-risk patients age 50 years or older. Authors ran a randomized controlled trial to determine whether there was a significant difference in within-30-day readmission rates between patients receiving usual care post-discharge and those receiving intervention from an MSW intern (one home visit and one to two phone calls). Results were obtained using a sample of hospitalized patients with a LACE index score of 7 or higher (N = 89). Analysis suggests that the intervention improved the likelihood of not being readmitted by some 22 percent (RR = 1.222; 95% CI = 1.063-1.405). The risk improvement with the intervention was highly statistically significant (p = .003). This study shows that a time-efficient care coordination intervention by MSW interns may decrease hospital readmission rates. Replications of this study in other communities, with more diverse populations, and with larger numbers of patients will indicate whether results are generalizable.