Clinical effectiveness, access to, and satisfaction with care using a telehomecare substitution intervention: a randomized controlled trial.
Clinical effectiveness, access to, and satisfaction with care using a telehomecare substitution intervention: a randomized controlled trial.
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DOI：
10.1155/2011/540138
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发表时间：
2011
影响因子：
4.4
通讯作者：
Weiner MG
中科院分区：
文献类型：
--
作者：
Bowles KH;Hanlon AL;Glick HA;Naylor MD;O'Connor M;Riegel B;Shih NW;Weiner MG
Background. Hospitalization accounts for 70% of heart failure (HF) costs; readmission rates at 30 days are 24% and rise to 50% by 90 days. Agencies anticipate that telehomecare will provide the close monitoring necessary to prevent HF readmissions. Methods and Results. Randomized controlled trial to compare a telehomecare intervention for patients 55 and older following hospital discharge for HF to usual skilled home care. Primary endpoints were 30- and 60-day all-cause and HF readmission, hospital days, and time to readmission or death. Secondary outcomes were access to care, emergency department (ED) use, and satisfaction with care. All-cause readmissions at 30 days (16% versus 19%) and over six months (46% versus 52%) were lower in the telehomecare group but were not statistically significant. Access to care and satisfaction were significantly higher for the telehomecare patients, including the number of in-person visits and days in home care. Conclusions. Patient acceptance of the technology and current home care policies and processes of care were barriers to gaining clinical effectiveness and efficiency.
