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An integrated hospital-to-home transitional care intervention for older adults with stroke and multimorbidity: A feasibility study.
- Source :
- Journal of Comorbidity; Jan-Dec2020, Vol. 10, p1-21, 21p
- Publication Year :
- 2020
-
Abstract
- Background: Stroke is the leading cause of death and adult disability in Canada. Eighty percent of older adults (≥65 years) who have suffered a stroke will return to their homes, and 60% will require ongoing rehabilitation. The transition between hospital and home is often fragmented, leading to adverse health outcomes, hospital readmissions, and increased health-care costs. This study examined the feasibility of a 6-month integrated transitional care stroke intervention (TCSI), and explored its effects on health outcomes, patient and provider experience, and cost in 30 community-living older adults (≥55 years) with stroke and multimorbidity (≥2 chronic conditions) using outpatient stroke rehabilitation services. Methods: The TCSI is a 6-month intervention delivered by an interprofessional (IP) team (occupational therapist, physiotherapist, speech language pathologist, registered nurse, social worker). It involved care coordination, home visiting, and IP case conferences, supported by a web-based application. A qualitative descriptive approach was used to explore the feasibility of implementing the intervention. A prospective one-group pretest/posttest was used to evaluate the effects of the intervention on health outcomes and use and costs of health services, from baseline to 6 months. Results: Participants had an average of eight comorbid conditions. The intervention was feasible and acceptable to both older adults and providers. From baseline to 6 months, there was no statistically significant difference in health outcomes. However, there was a significant reduction in the total per person use and costs of health services. Conclusions: This study established the feasibility of conducting a larger randomized controlled trial of this intervention. [ABSTRACT FROM AUTHOR]
- Subjects :
- HOSPITAL care of older people
CLINICAL trials
CONFIDENCE intervals
HOME care services
OUTPATIENT services in hospitals
INTEGRATED health care delivery
INTERPROFESSIONAL relations
RESEARCH methodology
MEDICAL care
MEDICAL care costs
MEDICAL rehabilitation
NURSES
HEALTH outcome assessment
PATIENTS
QUESTIONNAIRES
SOCIAL workers
SPEECH therapists
T-test (Statistics)
COMORBIDITY
QUALITATIVE research
PILOT projects
HOME environment
DISCHARGE planning
TREATMENT effectiveness
PRE-tests & post-tests
INDEPENDENT living
PATIENT readmissions
MOBILE apps
DATA analysis software
ATTITUDES of medical personnel
ADVERSE health care events
STROKE rehabilitation
STROKE patients
DESCRIPTIVE statistics
MANN Whitney U Test
Subjects
Details
- Language :
- English
- ISSN :
- 2235042X
- Volume :
- 10
- Database :
- Complementary Index
- Journal :
- Journal of Comorbidity
- Publication Type :
- Academic Journal
- Accession number :
- 147854707
- Full Text :
- https://doi.org/10.1177/2235042X19900451