Publication Type

Journal Article

Version

publishedVersion

Publication Date

4-2020

Abstract

BackgroundRehospitalizations are common in healthcare. They are costly for hospitals and patients and a substantial percentage are preventable, partly because hospital-to-community transitions are often unmanaged or poorly managed. In this study, we conducted a pragmatic randomized, controlled trial to evaluate the effectiveness of a new nurse–practitioner-led transitional care program called CareHub, piloted in Singapore’s National University Hospital.MethodsStudy population included all eligible cardiac patients admitted between July 2016 and November 2016. Patients were followed for six months post-discharge. Primary outcomes other than emergency department visits were all cardiac-related: number of readmissions, specialist visits, emergency department visits, and total days readmitted. Secondary outcomes: variables related to quality of life and transitional care. Regression analyses were used to estimate the intent-to-treat effect of CareHub and explore treatment heterogeneity.ResultsCareHub reduced the mean number of unplanned readmissions by 0.23 (a 39% reduction relative to control mean of 0.60 unplanned readmissions, p p = 0.10), mean number of total unplanned days in hospital by 2.2 (56% reduction relative to control mean of 4.0 days, p p ConclusionA carefully designed protocolized cardiac hospital-to-home transition program can reduce resource utilization while improving quality of life.

Discipline

Health Economics

Advisors/Committee Chairs

NA

Degree Awarded

PhD in Economics

Issue

2

First Page

55

Last Page

66

ISSN

2516-0435

Identifier

10.1177/2516043520914196

Publisher

Sage Publications

Additional URL

https://doi.org/10.1177/2516043520914196

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