Key result
Physical and/or occupational therapy added to telehealth and nursing care did not significantly reduce all-cause rehospitalization compared to nursing alone (overall cohort rate 31.06%).
Why the study?
Does the addition of physical and/or occupational therapy to home telehealth and nursing care reduce rehospitalization rates in patients with congestive heart failure?
Cohort (n=132)
Does the addition of physical and/or occupational therapy to home telehealth and nursing care reduce rehospitalization rates in patients with congestive heart failure?
The addition of physical or occupational therapy to home telehealth and nursing care did not significantly reduce 60-day all-cause rehospitalization rates in Medicare patients with heart failure.
Does not support adding therapy to telehealth nursing care; hypothesis-generating and requires prospective randomized confirmation.
PURPOSE: 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.
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Martin et al. (2016) conducted a cohort in Congestive heart failure (CHF) (n=132). Physical therapy (PT) and/or occupational therapy (OT) vs. Nursing only was evaluated on All-cause rehospitalization. Physical and/or occupational therapy added to telehealth and nursing care did not significantly reduce all-cause rehospitalization compared to nursing alone (overall cohort rate 31.06%).
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