Early geriatric follow-up visits to nursing home residents reduce the number of readmissions: a quasi-randomised controlled trial
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Nursing home residents have a high risk of being readmitted after hospitalisation. The objective of this study is to test whether an early geriatric follow-up visit can reduce readmissions among nursing home residents without increasing mortality. The main components of the intervention will also be quantified.
Materials and method
A quasi-randomised controlled design. A population of nursing-home residents aged 75 years or older admitted to hospital with one of nine medical diagnoses. All patients received comprehensive geriatric assessment before discharge. The intervention comprised a visit by a nurse and a doctor from a geriatric team the first weekday after discharge. Control group patients were offered a follow-up visit by their general practitioner 7–14 days after discharge.
Six hundred and forty-eight patients were included in the study between June 1st 2014 and December 15th 2016. In the intervention group, 13% were readmitted within 30 days after discharge, compared to 19% in the control group (p = 0.04). Adjusted hazard ratio = 0.63 (95% CI 0.42–0.95). The median length of hospital stay was 1 day for both groups. Neither 30 nor 90-day mortality were affected by the intervention. The most commonly registered intervention element was direct person-to-person contact between hospital and nursing home staff or relatives, followed by changes in medication and blood tests.
Early geriatric follow-up visits to recently discharged nursing home residents are a safe and effective way of reducing readmissions. Communication, changes in medication, and blood tests were the most frequently performed elements.
KeywordsNursing home residents Readmissions Length of hospital stay Mortality Follow-up visit Geriatrics
Compliance with ethical standards
Conflict of interest
There was no conflict of interest.
The study was reviewed by The Ethical Committee in The Central Denmark Region and was performed in accordance to the ethical standards of the Helsinki declaration.
The Ethical committee approved that patients did not sign a consent form, because of the organizational design. However, patients could decline to participate in the study at any time.
- 19.Deniger A, Troller P (2014) Geriatric transitional care and readmissions review. J Am Geriatr Soc 62:S221Google Scholar
- 27.Harvey P, Storer M, Berlowitz DJ, Jackson B, Hutchinson A, Lim WK (2014) Feasibility and impact of a post-discharge geriatric evaluation and management service for patients from residential care: The residential care intervention program in the elderly (RECIPE). BMC Geriatr 14:48CrossRefPubMedPubMedCentralGoogle Scholar
- 30.Should Dosa D (2006) I hospitalize my resident with nursing home-acquired pneumonia? J Am Med Dir Assoc 74–80:73Google Scholar
- 34.Shepperd S, Iliffe S, Doll Helen A, et al. (2016) Admission avoidance hospital at home. Cochrane Database of Systematic Reviews issue 9. CD007491Google Scholar
- 35.Goncalves-Bradley, Daniela C, Iliffe, et al. (2017) Early discharge hospital at home. Cochrane Database of Systematic Reviews issue 6. CD000356 Google Scholar