Can home visits help reduce hospital readmissions? Randomized controlled trial

• Published in: Journal of advanced nursing 2008-06, Vol.62 (5), p.585-595
• Main Authors: Wong, Frances Kam Yuet, Chow, Susan, Chung, Loretta, Chang, Katherine, Chan, Tony, Lee, Wai-Man, Lee, Rance
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Aged; Attitude to Health; Chronic Disease; Clinical trials; community care; Discharge; discharge planning; Female; Home health care; home visits; Hong Kong - epidemiology; hospital readmission; House Calls; Humans; Male; Nursing; Outcome Assessment (Health Care); Patient admissions; Patient Discharge - standards; Patient Readmission - statistics & numerical data; Patient Satisfaction - statistics & numerical data; Quality of care; randomized controlled trial; Severity of Illness Index; Studies
• ISSN: 0309-2402; 1365-2648
• DOI: 10.1111/j.1365-2648.2008.04631.x

Title.  Can home visits help reduce hospital readmissions? Randomized controlled trial Aim.  This paper is a report of a study to determine whether home visits can reduce hospital readmissions. Background.  The phenomenon of hospital readmission raises concerns about the quality of care and appropriate use of resources. Home visits after hospital discharge have been introduced to help reduce hospital readmission rates, but the results have not been conclusive. Method.  A randomized controlled trial was carried out from 2003 to 2005 . The control group (n = 166) received routine care and the study group (n = 166) received home visits from community nurses within 30 days of hospital discharge. Data were collected at baseline before discharge and 30 days after discharge. Findings.  Patients in the study group were statistically significantly more satisfied with their care. There were no statistically significant differences in other outcomes, including readmission rate, ADL score, self‐perceived life satisfaction and self‐perceived health. Regression analysis revealed that self‐perceived life satisfaction, self‐perceived health and disease category other than general symptoms were three statistically significant variables predicting hospital readmissions. Conclusion.  Preventive home visits were not effective in reducing hospital readmissions, but satisfaction with care was enhanced. Subjective well‐being is a key variable that warrants attention in the planning and evaluation of postdischarge home care.