Post-Acute Physician Home Visit Program
- Conditions
- A Patient Discharged From an Acute-care Hospital Who Had an Acute Illness
- Interventions
- Other: Home visit
- Registration Number
- NCT03178513
- Lead Sponsor
- Brigham and Women's Hospital
- Brief Summary
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.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 51
- 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
- Undomiciled
- In police custody
- Domestic violence screen positive
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Home visit Home visit A participant in this arm will receive a home visit after discharge from the hospital.
- Primary Outcome Measures
Name Time Method New or worsening symptoms 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.
- Secondary Outcome Measures
Name Time Method Receipt of prescribed medicines following discharge, y/n 30 days after discharge Pharmacy confirmation
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 I would like to ask you about some more problems that you might have faced after you left the hospital one month ago. I will read some statements and ask if you agree or disagree.
3-item Care Transition Measure, score 30 days after discharge Change in medication list due to home visit, y/n Day of home visit Physician-initiated medication change during 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
Trial Locations
- Locations (2)
Brigham and Women's Faulkner Hospital
🇺🇸Boston, Massachusetts, United States
Brigham and Women's Hospital
🇺🇸Boston, Massachusetts, United States