Effect of a Restorative Model of Posthospital Home Care on Hospital Readmissions

Objectives To compare readmissions of Medicare recipients of usual home care and a matched group of recipients of a restorative model of home care. Design Quasiexperimental; matched and unmatched. Setting Community, home care. Participants Seven hundred seventy individuals receiving care from a large home care agency after hospitalization. Intervention A restorative care model based on principles adapted from geriatric medicine, nursing, rehabilitation, goal attainment, chronic care management, and behavioral change theory. Measurements Hospital readmission, length of home care episode. Results Among the matched pairs, 13.2% of participants who received restorative care were readmitted to an acute hospital during the episode of home care, versus 17.6% of those who received usual care. Individuals receiving the restorative model of home care were 32% less likely to be readmitted than those receiving usual care (conditional odds ratio = 0.68, 95% confidence interval = 0.43–1.08). The mean length of home care episodes was 20.3 ± 14.8 days in the restorative care group and 29.1 ± 31.7 days in the usual care group (P