Incremental Benefit of a Home Visit Following Discharge for Patients with Multiple Chronic Conditions Receiving Transitional Care
Transitional care management is effective at reducing hospital readmissions among patients with multiple chronic conditions, but evidence is lacking on the relative benefit of the home visit as a component of transitional care. The sample included non-dual Medicaid recipients with multiple chronic c...
Gespeichert in:
Veröffentlicht in: | Population health management 2016-06, Vol.19 (3), p.163-170 |
---|---|
Hauptverfasser: | , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 170 |
---|---|
container_issue | 3 |
container_start_page | 163 |
container_title | Population health management |
container_volume | 19 |
creator | Jackson, Carlos Kasper, Elizabeth W. Williams, Christianna DuBard, C. Annette |
description | Transitional care management is effective at reducing hospital readmissions among patients with multiple chronic conditions, but evidence is lacking on the relative benefit of the home visit as a component of transitional care. The sample included non-dual Medicaid recipients with multiple chronic conditions enrolled in Community Care of North Carolina (CCNC), with a hospital discharge between July 2010 and December 2012. Using claims data and care management records, this study retrospectively examined whether home visits reduced the odds of 30-day readmission compared to less intensive transitional care support, using multivariate logistic regression to control for demographic and clinical characteristics. Additionally, the researchers examined group differences within clinical risk strata on inpatient admissions and total cost of care in the 6 months following hospital discharge. Of 35,174 discharges receiving transitional care from a CCNC care manager, 21% (N = 7468) included a home visit. In multivariate analysis, home visits significantly reduced the odds of readmission within 30 days (odds ratio = 0.52, 95% confidence interval 0.48–0.57). At the 6-month follow-up, home visits were associated with fewer inpatient admissions within 4 of 6 clinical risk strata, and lower total costs of care for highest risk patients (average per member per month cost difference $970;
P
|
doi_str_mv | 10.1089/pop.2015.0074 |
format | Article |
fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4913494</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1793901687</sourcerecordid><originalsourceid>FETCH-LOGICAL-c431t-4adfd974c6ee7c7902864ab17f4890f371db9742bcd7a3486daa2e7d26241f723</originalsourceid><addsrcrecordid>eNqFkc2P1SAUxYnROB-6dGtYuukTKC1lY6LV-UjGaMzollB6-x6GQgXeTFz6n0t9MxNduQLu_XHugYPQC0o2lHTy9RKWDSO02RAi-CN0TCVnlZCkeXy_7yQ9QicpfSek5S1pnqIj1vKasqY5Rr8uvYkwg8_a4XfgYbIZhwlrfBFmwN9sKuez4Fy4tX6L39tkdjpuAU8h4s8623Iz4Vubd_jj3mW7OMD9LgZvDe6DH222wSf8BQzYm1XhOmqf_lTLwF5HeIaeTNoleH63nqKvZx-u-4vq6tP5Zf_2qjLFa664HqdRCm5aAGHKA1nXcj1QMfFOkqkWdBxKmw1mFLrmXTtqzUCMrGWcToLVp-jNQXfZDzOMphiP2qkl2lnHnypoq_7teLtT23CjuKQ1l7wIvLoTiOHHHlJWc_kNcE57CPukqJC1JLTtREGrA2piSCnC9DCGErXGpkpsao1NrbEV_uXf3h7o-5wKUB-Atay9dxYGiPk_sr8ByNen9g</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1793901687</pqid></control><display><type>article</type><title>Incremental Benefit of a Home Visit Following Discharge for Patients with Multiple Chronic Conditions Receiving Transitional Care</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Jackson, Carlos ; Kasper, Elizabeth W. ; Williams, Christianna ; DuBard, C. Annette</creator><creatorcontrib>Jackson, Carlos ; Kasper, Elizabeth W. ; Williams, Christianna ; DuBard, C. Annette</creatorcontrib><description>Transitional care management is effective at reducing hospital readmissions among patients with multiple chronic conditions, but evidence is lacking on the relative benefit of the home visit as a component of transitional care. The sample included non-dual Medicaid recipients with multiple chronic conditions enrolled in Community Care of North Carolina (CCNC), with a hospital discharge between July 2010 and December 2012. Using claims data and care management records, this study retrospectively examined whether home visits reduced the odds of 30-day readmission compared to less intensive transitional care support, using multivariate logistic regression to control for demographic and clinical characteristics. Additionally, the researchers examined group differences within clinical risk strata on inpatient admissions and total cost of care in the 6 months following hospital discharge. Of 35,174 discharges receiving transitional care from a CCNC care manager, 21% (N = 7468) included a home visit. In multivariate analysis, home visits significantly reduced the odds of readmission within 30 days (odds ratio = 0.52, 95% confidence interval 0.48–0.57). At the 6-month follow-up, home visits were associated with fewer inpatient admissions within 4 of 6 clinical risk strata, and lower total costs of care for highest risk patients (average per member per month cost difference $970;
P
< 0.01). For complex chronic patients, home visits reduced the likelihood of a 30-day readmission by almost half compared to less intensive forms of nurse-led transitional care support. Higher risk patients experienced the greatest benefit in terms of number of inpatient admissions and total cost of care in the 6 months following discharge. (
Population Health Management
2016;19:163–170)</description><identifier>ISSN: 1942-7891</identifier><identifier>EISSN: 1942-7905</identifier><identifier>DOI: 10.1089/pop.2015.0074</identifier><identifier>PMID: 26431255</identifier><language>eng</language><publisher>United States: Mary Ann Liebert, Inc</publisher><subject>Adult ; Chronic Disease ; Female ; House Calls ; Humans ; Male ; Middle Aged ; Multiple Chronic Conditions ; North Carolina ; Original ; Original Articles ; Outcome Assessment (Health Care) ; Patient Readmission - trends ; Regression Analysis ; Transitional Care</subject><ispartof>Population health management, 2016-06, Vol.19 (3), p.163-170</ispartof><rights>2015, Mary Ann Liebert, Inc.</rights><rights>The Author(s) 2015; Published by Mary Ann Liebert, Inc. 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c431t-4adfd974c6ee7c7902864ab17f4890f371db9742bcd7a3486daa2e7d26241f723</citedby><cites>FETCH-LOGICAL-c431t-4adfd974c6ee7c7902864ab17f4890f371db9742bcd7a3486daa2e7d26241f723</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26431255$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jackson, Carlos</creatorcontrib><creatorcontrib>Kasper, Elizabeth W.</creatorcontrib><creatorcontrib>Williams, Christianna</creatorcontrib><creatorcontrib>DuBard, C. Annette</creatorcontrib><title>Incremental Benefit of a Home Visit Following Discharge for Patients with Multiple Chronic Conditions Receiving Transitional Care</title><title>Population health management</title><addtitle>Popul Health Manag</addtitle><description>Transitional care management is effective at reducing hospital readmissions among patients with multiple chronic conditions, but evidence is lacking on the relative benefit of the home visit as a component of transitional care. The sample included non-dual Medicaid recipients with multiple chronic conditions enrolled in Community Care of North Carolina (CCNC), with a hospital discharge between July 2010 and December 2012. Using claims data and care management records, this study retrospectively examined whether home visits reduced the odds of 30-day readmission compared to less intensive transitional care support, using multivariate logistic regression to control for demographic and clinical characteristics. Additionally, the researchers examined group differences within clinical risk strata on inpatient admissions and total cost of care in the 6 months following hospital discharge. Of 35,174 discharges receiving transitional care from a CCNC care manager, 21% (N = 7468) included a home visit. In multivariate analysis, home visits significantly reduced the odds of readmission within 30 days (odds ratio = 0.52, 95% confidence interval 0.48–0.57). At the 6-month follow-up, home visits were associated with fewer inpatient admissions within 4 of 6 clinical risk strata, and lower total costs of care for highest risk patients (average per member per month cost difference $970;
P
< 0.01). For complex chronic patients, home visits reduced the likelihood of a 30-day readmission by almost half compared to less intensive forms of nurse-led transitional care support. Higher risk patients experienced the greatest benefit in terms of number of inpatient admissions and total cost of care in the 6 months following discharge. (
Population Health Management
2016;19:163–170)</description><subject>Adult</subject><subject>Chronic Disease</subject><subject>Female</subject><subject>House Calls</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multiple Chronic Conditions</subject><subject>North Carolina</subject><subject>Original</subject><subject>Original Articles</subject><subject>Outcome Assessment (Health Care)</subject><subject>Patient Readmission - trends</subject><subject>Regression Analysis</subject><subject>Transitional Care</subject><issn>1942-7891</issn><issn>1942-7905</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>1-M</sourceid><sourceid>EIF</sourceid><recordid>eNqFkc2P1SAUxYnROB-6dGtYuukTKC1lY6LV-UjGaMzollB6-x6GQgXeTFz6n0t9MxNduQLu_XHugYPQC0o2lHTy9RKWDSO02RAi-CN0TCVnlZCkeXy_7yQ9QicpfSek5S1pnqIj1vKasqY5Rr8uvYkwg8_a4XfgYbIZhwlrfBFmwN9sKuez4Fy4tX6L39tkdjpuAU8h4s8623Iz4Vubd_jj3mW7OMD9LgZvDe6DH222wSf8BQzYm1XhOmqf_lTLwF5HeIaeTNoleH63nqKvZx-u-4vq6tP5Zf_2qjLFa664HqdRCm5aAGHKA1nXcj1QMfFOkqkWdBxKmw1mFLrmXTtqzUCMrGWcToLVp-jNQXfZDzOMphiP2qkl2lnHnypoq_7teLtT23CjuKQ1l7wIvLoTiOHHHlJWc_kNcE57CPukqJC1JLTtREGrA2piSCnC9DCGErXGpkpsao1NrbEV_uXf3h7o-5wKUB-Atay9dxYGiPk_sr8ByNen9g</recordid><startdate>20160601</startdate><enddate>20160601</enddate><creator>Jackson, Carlos</creator><creator>Kasper, Elizabeth W.</creator><creator>Williams, Christianna</creator><creator>DuBard, C. Annette</creator><general>Mary Ann Liebert, Inc</general><scope>1-M</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20160601</creationdate><title>Incremental Benefit of a Home Visit Following Discharge for Patients with Multiple Chronic Conditions Receiving Transitional Care</title><author>Jackson, Carlos ; Kasper, Elizabeth W. ; Williams, Christianna ; DuBard, C. Annette</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c431t-4adfd974c6ee7c7902864ab17f4890f371db9742bcd7a3486daa2e7d26241f723</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Chronic Disease</topic><topic>Female</topic><topic>House Calls</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multiple Chronic Conditions</topic><topic>North Carolina</topic><topic>Original</topic><topic>Original Articles</topic><topic>Outcome Assessment (Health Care)</topic><topic>Patient Readmission - trends</topic><topic>Regression Analysis</topic><topic>Transitional Care</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jackson, Carlos</creatorcontrib><creatorcontrib>Kasper, Elizabeth W.</creatorcontrib><creatorcontrib>Williams, Christianna</creatorcontrib><creatorcontrib>DuBard, C. Annette</creatorcontrib><collection>Mary Ann Liebert Online - Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Population health management</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jackson, Carlos</au><au>Kasper, Elizabeth W.</au><au>Williams, Christianna</au><au>DuBard, C. Annette</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incremental Benefit of a Home Visit Following Discharge for Patients with Multiple Chronic Conditions Receiving Transitional Care</atitle><jtitle>Population health management</jtitle><addtitle>Popul Health Manag</addtitle><date>2016-06-01</date><risdate>2016</risdate><volume>19</volume><issue>3</issue><spage>163</spage><epage>170</epage><pages>163-170</pages><issn>1942-7891</issn><eissn>1942-7905</eissn><abstract>Transitional care management is effective at reducing hospital readmissions among patients with multiple chronic conditions, but evidence is lacking on the relative benefit of the home visit as a component of transitional care. The sample included non-dual Medicaid recipients with multiple chronic conditions enrolled in Community Care of North Carolina (CCNC), with a hospital discharge between July 2010 and December 2012. Using claims data and care management records, this study retrospectively examined whether home visits reduced the odds of 30-day readmission compared to less intensive transitional care support, using multivariate logistic regression to control for demographic and clinical characteristics. Additionally, the researchers examined group differences within clinical risk strata on inpatient admissions and total cost of care in the 6 months following hospital discharge. Of 35,174 discharges receiving transitional care from a CCNC care manager, 21% (N = 7468) included a home visit. In multivariate analysis, home visits significantly reduced the odds of readmission within 30 days (odds ratio = 0.52, 95% confidence interval 0.48–0.57). At the 6-month follow-up, home visits were associated with fewer inpatient admissions within 4 of 6 clinical risk strata, and lower total costs of care for highest risk patients (average per member per month cost difference $970;
P
< 0.01). For complex chronic patients, home visits reduced the likelihood of a 30-day readmission by almost half compared to less intensive forms of nurse-led transitional care support. Higher risk patients experienced the greatest benefit in terms of number of inpatient admissions and total cost of care in the 6 months following discharge. (
Population Health Management
2016;19:163–170)</abstract><cop>United States</cop><pub>Mary Ann Liebert, Inc</pub><pmid>26431255</pmid><doi>10.1089/pop.2015.0074</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1942-7891 |
ispartof | Population health management, 2016-06, Vol.19 (3), p.163-170 |
issn | 1942-7891 1942-7905 |
language | eng |
recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4913494 |
source | MEDLINE; Alma/SFX Local Collection |
subjects | Adult Chronic Disease Female House Calls Humans Male Middle Aged Multiple Chronic Conditions North Carolina Original Original Articles Outcome Assessment (Health Care) Patient Readmission - trends Regression Analysis Transitional Care |
title | Incremental Benefit of a Home Visit Following Discharge for Patients with Multiple Chronic Conditions Receiving Transitional Care |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-09T17%3A44%3A39IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Incremental%20Benefit%20of%20a%20Home%20Visit%20Following%20Discharge%20for%20Patients%20with%20Multiple%20Chronic%20Conditions%20Receiving%20Transitional%20Care&rft.jtitle=Population%20health%20management&rft.au=Jackson,%20Carlos&rft.date=2016-06-01&rft.volume=19&rft.issue=3&rft.spage=163&rft.epage=170&rft.pages=163-170&rft.issn=1942-7891&rft.eissn=1942-7905&rft_id=info:doi/10.1089/pop.2015.0074&rft_dat=%3Cproquest_pubme%3E1793901687%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1793901687&rft_id=info:pmid/26431255&rfr_iscdi=true |