Pedersen Lene Holst, Brynningsen Peter, Foss Catherine Hauerslev, Gregersen Merete, Barat Ishay, Damsgaard Else Marie
Department of Geriatrics, Aarhus University Hospital, Palle-Juul Jensens Boulevard 99, Building J, 8200, Aarhus N, Denmark.
The Regional Hospital in Horsens, Sundvej 30, 8700, Horsens, Denmark.
Eur Geriatr Med. 2018 Oct;9(5):613-621. doi: 10.1007/s41999-018-0078-7. Epub 2018 Jun 25.
The aim of this study was to look specifically at patients readmitted in our previously published study. We wanted to assess the percentage of avoidable readmissions among patients receiving an early geriatric follow-up visit compared to a control group receiving usual care.
The original population was geriatric patients primarily admitted to hospital with one of nine medical diagnoses and included in a quasi randomized controlled trial. They received either an early geriatric follow-up visit or usual care after hospital discharge. Only patients with an unplanned readmission were included in this subgroup analysis. Medical records of the readmitted patients were assessed by two reviewers. Each readmission was classified as either avoidable or unavoidable. An avoidable readmission was defined as being clinically related to index admissions.
Between June 2014 and November 2015, 2076 patients were included in the original study. Of these, 216 patients were readmitted. Almost half of avoidable readmissions happened during the first week after hospital discharge. Thirty-four (41%) of 83 readmissions in the intervention group were assessed as avoidable compared to 72 (54%) of 133 readmissions in the control group (p = 0.06).
An early follow-up visit after hospital discharge seems to reduce avoidable readmissions among geriatric patients.
本研究旨在专门观察我们之前发表的研究中再次入院的患者。我们希望评估接受早期老年医学随访的患者与接受常规护理的对照组相比,可避免再次入院的百分比。
原始人群为主要因九种医学诊断之一入院的老年患者,并纳入了一项准随机对照试验。他们在出院后接受早期老年医学随访或常规护理。该亚组分析仅纳入了非计划再次入院的患者。两名评估人员对再次入院患者的病历进行了评估。每次再次入院被分类为可避免或不可避免。可避免的再次入院被定义为与首次入院存在临床关联。
在2014年6月至2015年11月期间,2076名患者被纳入原始研究。其中,216名患者再次入院。几乎一半的可避免再次入院发生在出院后的第一周。干预组83次再次入院中有34次(41%)被评估为可避免,而对照组133次再次入院中有72次(54%)被评估为可避免(p = 0.06)。
出院后早期随访似乎可减少老年患者的可避免再次入院情况。