Implementation of discharge management for geriatric patients at risk of readmission or institutionalization

in International Journal for Quality in Health Care (2006), 18(5), 352-358

Objective. To evaluate whether implementation of discharge management by trained social workers or nurses reduces hospital readmissions and institutionalizations of geriatric patients in a real-world ... [more ▼]

Objective. To evaluate whether implementation of discharge management by trained social workers or nurses reduces hospital readmissions and institutionalizations of geriatric patients in a real-world setting. Design. Quasi-experimental design. Setting. Six general hospitals in Belgium. Participants. A representative sample of 824 patients, 355 of whom were assigned to the experimental group receiving comprehensive discharge management and 469 to the control group receiving usual care. Inclusion criteria were patients admitted to a geriatric, rehabilitation, or internal medicine ward, not residing in a nursing home, and showing risk of readmission or institutionalization on admission in the hospital. Intervention. In-hospital discharge planning according to a case management protocol allowing for adjustment to participating hospitals' case mix and patients' and families' specific needs. Main outcome measures. Hospital readmission within 15 and 90 days post discharge; institutionalization at discharge and within 15 and 90 days post discharge. Results. Discharge management resulted in fewer institutionalizations (n = 53; 14.9%) compared with usual care (n = 130; 23.7%) (adjusted odds ratio = 0.47; CI 95% = 0.31-0.70). Readmission rates between the intervention and usual care group were not significantly different. Conclusions. This implementation project showed that a discharge planning intervention can reduce institutionalization rates of elderly patients in real-life settings. [less ▲]

Pilootproject : ontslagmanagement in Belgische ziekenhuizen. [Pilot study : discharge management in Belgian hospitals]. Final report, 2000

Report (2000)

Pilootproject : Ontslagmanagement in Belgische Psyciatrische Ziekenhuizen. [Pilot study : discharge management in Belgian psychiatric hospitals]. Final report, 2000

Report (2000)

Etude pilote : Case management intégré dans les hôpitaux belges.

Report (1999)

Case management : een zorgverleningsmodel voor hoog-risico bejaarden in de thuiszorg. [Case management : a health care model for high risk elderly in the home care]. Final report, 1998

Report (1998)

Case Management : Gestion de situations critiques pour personnes âgées à domicile.

Report (1998)

Case management voor psychogeriatrishe patiënten: gezondheidstoestand van deze ouderen en de zorgbelasting van hun centrale verzorgers

in Acta Hospitalia (1996), 4