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Impact of Program Changes Including Telemedicine and Telephonic Care During the COVID-19 Pandemic in Preventing 30-Day Hospital Readmission for Patients in a Care Transitions Program.
- Source :
- Journal of Primary Care & Community Health; 1/27/2024, p1-9, 9p
- Publication Year :
- 2024
-
Abstract
- Introduction/Objectives: To describe health outcomes of older adults enrolled in the Mayo Clinic Care Transitions (MCCT) program before and during the COVID-19 pandemic compared to unenrolled patients. Methods: We conducted a retrospective cohort study of adults (age >60 years) in the MCCT program compared to a usual care control group from January 1, 2019, to September 20, 2022. The MCCT program involved a home, telephonic, or telemedicine visit by an advanced care provider. Outcomes were 30- and 180-day hospital readmissions, emergency department (ED) visit, and mortality. We performed a subgroup analysis after March 1, 2020 (during the pandemic). We analyzed data with Cox proportional hazards regression models and hazard ratios (HRs) with 95% CIs. Results: Of the 1,012 patients total, 354 were in the MCCT program and 658 were in the usual care group with a mean (SD) age of 81.1 (9.1) years overall. Thirty-day readmission was 16.9% (60 of 354) for MCCT patients and 14.7% (97 of 658) for usual care patients (HR, 1.24; 95% CI, 0.88-1.75). During the pandemic, the 30-day readmission rate was 15.1% (28 of 186) for MCCT patients and 14.9% (68 of 455) for usual care patients (HR, 1.20; 95% CI, 0.75-1.91). There was no difference between groups for 180-day hospitalization, 30- or 180-day ED visit, and 30- or 180-day mortality. Conclusions: Numerous factors involving patients, providers, and health care delivery systems during the pandemic most likely contributed to these findings. [ABSTRACT FROM AUTHOR]
- Subjects :
- EVALUATION of medical care
CONFIDENCE intervals
HOSPITAL emergency services
TRANSITIONAL care
PATIENT readmissions
RETROSPECTIVE studies
HOSPITAL mortality
COMPARATIVE studies
PRIMARY health care
RESEARCH funding
DESCRIPTIVE statistics
HOSPITAL care
MEDICAL appointments
TELEMEDICINE
COVID-19 pandemic
LONGITUDINAL method
PROPORTIONAL hazards models
Subjects
Details
- Language :
- English
- ISSN :
- 21501319
- Database :
- Complementary Index
- Journal :
- Journal of Primary Care & Community Health
- Publication Type :
- Academic Journal
- Accession number :
- 175032630
- Full Text :
- https://doi.org/10.1177/21501319241226547