Telephone discharge support for frail, vulnerable older people discharged from hospital: Impact on readmission rates - Participant and general practitioner feedback.

AUSTRALASIAN JOURNAL ON AGEING(2018)

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摘要
ObjectiveTo assess the use and acceptability to older participants and general practitioners (GPs) of telephone support postdischarge to reduce readmissions. MethodsA prospective cohort study of older people after discharge from a specialist geriatric unit, and comparison with a previous cohort. Telephone follow-up calls were made fortnightly for three months. Structured questionnaires were used to obtain feedback from participants and GPs. ResultsReadmission rates were high, 40%, despite the intervention. This rate had significantly increased since the earlier cohort. Almost one-fifth of the sample (19%) were readmitted before the first telephone call. Subsequent readmissions were not related to whether participants had reported deteriorating health during the preceding telephone call. Feedback on the intervention from both participants and GPs was supportive. ConclusionsTelephone follow-up as we used it did not reduce readmission rates. However, it was well received and appreciated by participants. It is possible the telephone calls were not made early enough or frequently enough to achieve the desired outcome. Practice Impact: The time after discharge is challenging for older people who may have high level of unmet need and frequently experience early readmission. Telephone support is suggested as an intervention. Despite this intervention, there were high numbers of readmissions, many occurring within the first 14 days. However, participants reported the interventionaddressed needs such as feeling isolated or needing information.
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关键词
discharge support,frailty,patient discharge,patient readmission,primary care
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