Key result
Follow-up visits by a multidisciplinary geriatric team reduced 30-day unplanned hospital readmissions in older patients discharged to a skilled nursing facility (HR 0.68; 95% CI 0.54-0.87; p=0.002).
Why the study?
Older patients with frailty face the highest risk of hospital readmission, and it was unknown whether follow-up visits by an outgoing multidisciplinary geriatric team reduce unplanned readmissions for patients discharged to a skilled nursing facility.
Does follow-up visits by an outgoing multidisciplinary geriatric team reduce unplanned hospital readmission in older patients discharged to a skilled nursing facility?
Cohort (n=847)
No
Does follow-up visits by an outgoing multidisciplinary geriatric team reduce unplanned hospital readmission in older patients discharged to a skilled nursing facility?
Hazard Ratio: 0.68 (95% CI 0.54–0.87)
Absolute Event Rate: 30.2% vs 39.8%
p-value: p=0.002
Follow-up visits by a multidisciplinary geriatric team within 7 days of discharge to a skilled nursing facility significantly reduces 30-day unplanned hospital readmissions in older patients.
OGT follow-up was associated with lower 30-day readmission after SNF discharge; leaves open whether randomized trials will confirm benefit.
INTRODUCTION: Hospital readmission is a burden to patients, relatives and society. Older patients with frailty are at highest risk of readmission and its negative outcomes. OBJECTIVE: We aimed at examining whether follow-up visits by an outgoing multidisciplinary geriatric team (OGT) reduces unplanned hospital readmission in patients discharged to a skilled nursing facility (SNF). DESIGN: A retrospective single-centre before-and-after cohort study. SETTING AND PARTICIPANTS: Study population included all hospitalised patients discharged from a Danish geriatric department to an SNF during 1 January 2016-25 February 2020. To address potential changes in discharge and readmission patterns during the study period, patients discharged from the same geriatric department to own home were also assessed. INTERVENTION: OGT visits at SNF within 7 days following discharge. Patients discharged to SNF before 12 March 2018 did not receive OGT (-OGT). Patients discharged to SNF on or after 12 March 2018 received the intervention (+OGT). MAIN OUTCOME MEASURES: Unplanned hospital readmission between 4 hours and 30 days following initial discharge. RESULTS: Totally 847 patients were included (440 -OGT; 407 +OGT). No differences were seen between the two groups regarding age, sex, activities of daily living (ADLs), Charlson Comorbidity Index (CCI) or 30-day mortality. The cumulative incidence of readmission was 39.8% (95% CI 35.2% to 44.8%, n=162) in -OGT and 30.2% (95% CI 25.8% to 35.2%, n=113) in +OGT. The unadjusted risk (HR (95% CI)) of readmission was 0.68 (0.54 to 0.87, p=0.002) in +OGT compared with -OGT, and remained significantly lower (0.72 (0.57 to 0.93, p=0.011)) adjusting for age, length of stay, sex, ADL and CCI. For patients discharged to own home the risk of readmission remained unchanged during the study period. CONCLUSION: Follow-up visits by OGT to patients discharged to temporary care at an SNF significantly reduced 30-day readmission in older patients.
No takes yet. Share an insight, caveat, or question.
Thomsen et al. (2021) conducted a cohort in Older patients discharged to temporary care at a skilled nursing facility (n=847). Follow-up visits by an outgoing multidisciplinary geriatric team (OGT) vs. No OGT visits was evaluated on Unplanned hospital readmission between 4 hours and 30 days following initial discharge (HR 0.68, 95% CI 0.54 to 0.87, p=0.002). Follow-up visits by a multidisciplinary geriatric team reduced 30-day unplanned hospital readmissions in older patients discharged to a skilled nursing facility (HR 0.68; 95% CI 0.54-0.87; p=0.002).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: