Wong Frances Kam Yuet, Chow Susan, Chung Loretta, Chang Katherine, Chan Tony, Lee Wai-Man, Lee Rance
School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.
J Adv Nurs. 2008 Jun;62(5):585-95. doi: 10.1111/j.1365-2648.2008.04631.x.
This paper is a report of a study to determine whether home visits can reduce hospital readmissions. Background. The phenomenon of hospital readmission raises concerns about the quality of care and appropriate use of resources. Home visits after hospital discharge have been introduced to help reduce hospital readmission rates, but the results have not been conclusive.
A randomized controlled trial was carried out from 2003 to 2005 . The control group (n = 166) received routine care and the study group (n = 166) received home visits from community nurses within 30 days of hospital discharge. Data were collected at baseline before discharge and 30 days after discharge.
Patients in the study group were statistically significantly more satisfied with their care. There were no statistically significant differences in other outcomes, including readmission rate, ADL score, self-perceived life satisfaction and self-perceived health. Regression analysis revealed that self-perceived life satisfaction, self-perceived health and disease category other than general symptoms were three statistically significant variables predicting hospital readmissions.
Preventive home visits were not effective in reducing hospital readmissions, but satisfaction with care was enhanced. Subjective well-being is a key variable that warrants attention in the planning and evaluation of postdischarge home care.
本文是一项关于确定家访是否能降低医院再入院率的研究报告。背景：医院再入院现象引发了对医疗质量和资源合理利用的关注。出院后进行家访旨在帮助降低医院再入院率，但结果尚无定论。
于2003年至2005年开展了一项随机对照试验。对照组（n = 166）接受常规护理，研究组（n = 166）在出院后30天内接受社区护士的家访。在出院前的基线和出院后30天收集数据。
研究组患者对护理的满意度在统计学上显著更高。在其他结果方面，包括再入院率、日常生活活动能力评分、自我感知的生活满意度和自我感知的健康状况，均无统计学上的显著差异。回归分析显示，自我感知的生活满意度、自我感知的健康状况以及除一般症状外的疾病类别是预测医院再入院的三个具有统计学意义的变量。
预防性家访在降低医院再入院率方面无效，但护理满意度得到了提高。主观幸福感是出院后家庭护理规划和评估中值得关注的关键变量。
