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A Retrospective Comparison of Home Telehealth and Nursing Care With or Without Rehabilitation Therapy on Rehospitalization Rates of Individuals With Heart Failure

MARTIN S; ANDERSON B; VINCENZO JL; ZAI SY
J CARDIOPULM REHABIL PREV , 2017, vol. 37, n° 3, p. 207-213
Doc n°: 185840
Localisation : Rééducation CHU Brabois Adultes

D.O.I. : http://dx.doi.org/DOI:10.1097/HCR.0000000000000221
Descripteurs : FA333 - INFARCTUS DU MYOCARDE, VE1 - TELEMEDECINE

Congestive heart failure (CHF) is the most common reason for
rehospitalization among the aging population, accounting for one-fifth of all
hospital admissions. To date, there is no research comparing the
rehospitalization rates between patients with CHF (PWCHF) who receive telehealth
and home health nursing care versus a multidisciplinary team consisting of
telehealth, home nursing, physical therapy (PT), and/or occupational therapy (OT). METHODS: A retrospective analysis was performed with 132 Medicare - Part A
home health patients discharged from an inpatient setting with a primary or
secondary diagnosis of CHF receiving daily telehealth over the course of 1 year.
Allscripts Home Care and Lifestream software was used to query data from patient
records. Rehospitalization rates were analyzed using Cochran-Mantel-Haenszel
tests. Patients were divided into 3 groups: (1) nursing only; (2) nursing and PT
or OT; or (3) nursing, PT, and OT. RESULTS: A total of 41 of the 132 patients
(31.06%) were rehospitalized during their home health 60-day episode of care.
This percentage includes all-cause rehospitalizations. Cochran-Mantel-Haenszel
tests indicated there were no differences in rehospitalization rates between the
3 groups after controlling for the confounding variables : (1) multiple
hospitalizations (P = .15); (2) history of falls (P = .16); or (3) depression (P = .18). CONCLUSIONS: There was no statistically significant difference between
the 3 groups for all-cause rehospitalization rates. Further prospective research
is required to determine best practices and multidisciplinary protocols to
further reduce rehospitalization rates in this population.

Langue : ANGLAIS

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