Post-Acute Physician Home Visits: A Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 51
- 试验地点
- 4
- 主要终点
- New or worsening symptoms
研究概览
简要总结
New or worsening symptoms following discharge from the hospital likely leads to unplanned readmission. These rates are higher than desired and costly to patients, payers, and providers. Many interventions have unsuccessfully attempted to reduce readmissions, but few have provided in-home personnel to patients transitioning from acute care back to ambulatory care. Still fewer have involved a physician in the home. We therefore will test the effect of a physician home visit to a patient's home who was discharged in the last 4 days.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Resides within either a 5-mile or 20-minute driving radius of Brigham and Women's Hospital (BWH) or Brigham and Women's Faulkner Hospital (BWFH) emergency room
- •Has capacity to consent to study
- •>=18 years old
排除标准
- •Undomiciled
- •In police custody
- •Domestic violence screen positive
研究组 & 干预措施
Home visit
A participant in this arm will receive a home visit after discharge from the hospital.
干预措施: Home visit (Other)
Usual Care
A participant in this arm will not receive a home visit after discharge from the hospital.
结局指标
主要结局
New or worsening symptoms
时间窗: 30 days after discharge from hospital
"Since you got home from the hospital, have you had any symptoms at all?" If no, stop. If yes, continue. "I'm going to read off a list of symptoms, and I want you to tell me if that symptom is new or has gotten worse since you left the hospital. Please don't include symptoms that have stayed the same since you were in the hospital." For each affirmative, double check if the symptom is new or has gotten worse since getting out of the hospital. Only if new or worse, mark yes.
次要结局
- Receipt of prescribed medicines following discharge, y/n(30 days after discharge)
- Primary care provider follow-up within 14 days, y/n(Day of discharge to 14 days later)
- Total reimbursement, 30-days post discharge(Day of discharge to 30 days later)
- Total cost, 30-days post discharge(Day of discharge to 30 days later)
- Ability to carry out the discharge plan, score(30 days after discharge)
- 3-item Care Transition Measure, score(30 days after discharge)
- Change in medication list due to home visit, y/n(Day of home visit)
- Unplanned 30-day readmission(s) after index hospitalization, #(30 days after discharge)
- Unplanned 30-day readmission(s) after index hospitalization, y/n(30 days after discharge)
研究者
Jeffrey L. Schnipper, MD.,MPH.
Associate Professor
Brigham and Women's Hospital