A Randomized Trial of Telenursing to Reduce Hospitalization for Heart Failure: Patient-Centered Outcomes and Nursing Indicators

This trial compared 3 post-hospitalization nursing care models for reducing congestive heart failure (CHF) readmission charges during 180-days of follow-up. Subjects received in-person visits at baseline and 60 days plus 1 of 3 care modalities in the interim: (a) video-based home telecare; (b) telep...

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Bibliographic Details
Published in:Home health care services quarterly 2003-01, Vol.22 (1), p.1-20
Main Authors: Jerant, Anthony F., Azari, Rahman, Martinez, Carmen, Nesbitt, Thomas S.
Format: Article
Language:English
Subjects:
Aged
California
congestive heart failure
cost and cost analysis
disease management
Emergency Service, Hospital - utilization
Female
Health administration
Health Services Research
Heart Failure - complications
Heart Failure - nursing
home care services
Home Care Services - organization & administration
home nursing
home telecare
hospitalization
Humans
Male
Models, Nursing
Nurse-Patient Relations
Outcome Assessment (Health Care)
Patient Readmission
Patient-Centered Care
randomized controlled trials
Self Care
Telemedicine
telephone
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Summary:This trial compared 3 post-hospitalization nursing care models for reducing congestive heart failure (CHF) readmission charges during 180-days of follow-up. Subjects received in-person visits at baseline and 60 days plus 1 of 3 care modalities in the interim: (a) video-based home telecare; (b) telephone calls; and (c) usual care. CHF-related read-mission charges were > 80% lower in the telenursing groups compared to usual care, and these groups also had significantly fewer CHF-related emergency visits. In-person visits were more than 3 times longer than telenursing visits (p < 0.0001), only partially due to added travel time. Patient self-care adherence, medications, health status, and satisfaction did not significantly differ between groups. Telenursing can reduce CHF hospitalizations and allow increased frequency of communication with patients.
ISSN:0162-1424
1545-0856
DOI:10.1300/J027v22n01_01