Clinical Effectiveness, Access to, and Satisfaction with Care Using a Telehomecare Substitution Intervention: A Randomized Controlled Trial
Background. Hospitalization accounts for 70% of heart failure (HF) costs; readmission rates at 30 days are 24% and rise to 50% by 90 days. Agencies anticipate that telehomecare will provide the close monit...
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2011-01-01
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| Series: | International Journal of Telemedicine and Applications |
| Online Access: | http://dx.doi.org/10.1155/2011/540138 |
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| Summary: | Background.
Hospitalization accounts for 70% of heart
failure (HF) costs; readmission rates at 30 days
are 24% and rise to 50% by 90 days.
Agencies anticipate that telehomecare will
provide the close monitoring necessary to
prevent HF readmissions. Methods and
Results. Randomized controlled trial to
compare a telehomecare intervention for patients
55 and older following hospital discharge for HF
to usual skilled home care. Primary endpoints
were 30- and 60-day all-cause and HF readmission,
hospital days, and time to readmission or death.
Secondary outcomes were access to care,
emergency department (ED) use, and satisfaction
with care. All-cause readmissions at 30 days
(16% versus 19%) and over six months
(46% versus 52%) were lower in the
telehomecare group but were not statistically
significant. Access to care and satisfaction
were significantly higher for the telehomecare
patients, including the number of in-person
visits and days in home care.
Conclusions. Patient acceptance
of the technology and current home care policies
and processes of care were barriers to gaining
clinical effectiveness and
efficiency. |
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| ISSN: | 1687-6415 1687-6423 |