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...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2011-01-01
|
| Series: | International Journal of Telemedicine and Applications |
| Online Access: | http://dx.doi.org/10.1155/2011/540138 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832548126496391168 |
|---|---|
| author | Kathryn H. Bowles Alexandra L. Hanlon Henry A. Glick Mary D. Naylor Melissa O'Connor Barbara Riegel Nai-Wei Shih Mark G. Weiner |
| author_facet | Kathryn H. Bowles Alexandra L. Hanlon Henry A. Glick Mary D. Naylor Melissa O'Connor Barbara Riegel Nai-Wei Shih Mark G. Weiner |
| author_sort | Kathryn H. Bowles |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-7bc3c72bc87c41d9b6ff0af25c8aeb80 |
| institution | Kabale University |
| issn | 1687-6415 1687-6423 |
| language | English |
| publishDate | 2011-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Telemedicine and Applications |
| spelling | doaj-art-7bc3c72bc87c41d9b6ff0af25c8aeb802025-02-03T06:42:11ZengWileyInternational Journal of Telemedicine and Applications1687-64151687-64232011-01-01201110.1155/2011/540138540138Clinical Effectiveness, Access to, and Satisfaction with Care Using a Telehomecare Substitution Intervention: A Randomized Controlled TrialKathryn H. Bowles0Alexandra L. Hanlon1Henry A. Glick2Mary D. Naylor3Melissa O'Connor4Barbara Riegel5Nai-Wei Shih6Mark G. Weiner7University of Pennsylvania School of Nursing, 418 Curie Boulevard, Philadelphia, PA 19104, USAUniversity of Pennsylvania School of Nursing, 418 Curie Boulevard, Philadelphia, PA 19104, USAUniversity of Pennsylvania School of Medicine, 423 Guardian Drive, Philadelphia, PA 19104, USAUniversity of Pennsylvania School of Nursing, 418 Curie Boulevard, Philadelphia, PA 19104, USAUniversity of Pennsylvania School of Nursing, 418 Curie Boulevard, Philadelphia, PA 19104, USAUniversity of Pennsylvania School of Nursing, 418 Curie Boulevard, Philadelphia, PA 19104, USAUniversity of Pennsylvania School of Nursing, 418 Curie Boulevard, Philadelphia, PA 19104, USAUniversity of Pennsylvania School of Medicine, 423 Guardian Drive, Philadelphia, PA 19104, USABackground. 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.http://dx.doi.org/10.1155/2011/540138 |
| spellingShingle | Kathryn H. Bowles Alexandra L. Hanlon Henry A. Glick Mary D. Naylor Melissa O'Connor Barbara Riegel Nai-Wei Shih Mark G. Weiner Clinical Effectiveness, Access to, and Satisfaction with Care Using a Telehomecare Substitution Intervention: A Randomized Controlled Trial International Journal of Telemedicine and Applications |
| title | Clinical Effectiveness, Access to, and Satisfaction with Care Using a Telehomecare Substitution Intervention: A Randomized Controlled Trial |
| title_full | Clinical Effectiveness, Access to, and Satisfaction with Care Using a Telehomecare Substitution Intervention: A Randomized Controlled Trial |
| title_fullStr | Clinical Effectiveness, Access to, and Satisfaction with Care Using a Telehomecare Substitution Intervention: A Randomized Controlled Trial |
| title_full_unstemmed | Clinical Effectiveness, Access to, and Satisfaction with Care Using a Telehomecare Substitution Intervention: A Randomized Controlled Trial |
| title_short | Clinical Effectiveness, Access to, and Satisfaction with Care Using a Telehomecare Substitution Intervention: A Randomized Controlled Trial |
| title_sort | clinical effectiveness access to and satisfaction with care using a telehomecare substitution intervention a randomized controlled trial |
| url | http://dx.doi.org/10.1155/2011/540138 |
| work_keys_str_mv | AT kathrynhbowles clinicaleffectivenessaccesstoandsatisfactionwithcareusingatelehomecaresubstitutioninterventionarandomizedcontrolledtrial AT alexandralhanlon clinicaleffectivenessaccesstoandsatisfactionwithcareusingatelehomecaresubstitutioninterventionarandomizedcontrolledtrial AT henryaglick clinicaleffectivenessaccesstoandsatisfactionwithcareusingatelehomecaresubstitutioninterventionarandomizedcontrolledtrial AT marydnaylor clinicaleffectivenessaccesstoandsatisfactionwithcareusingatelehomecaresubstitutioninterventionarandomizedcontrolledtrial AT melissaoconnor clinicaleffectivenessaccesstoandsatisfactionwithcareusingatelehomecaresubstitutioninterventionarandomizedcontrolledtrial AT barbarariegel clinicaleffectivenessaccesstoandsatisfactionwithcareusingatelehomecaresubstitutioninterventionarandomizedcontrolledtrial AT naiweishih clinicaleffectivenessaccesstoandsatisfactionwithcareusingatelehomecaresubstitutioninterventionarandomizedcontrolledtrial AT markgweiner clinicaleffectivenessaccesstoandsatisfactionwithcareusingatelehomecaresubstitutioninterventionarandomizedcontrolledtrial |