The effects of telehealth use for post-acute rehabilitation patient outcomes.

Introduction Previous research has shown that home telehealth services can reduce hospitalisations and emergency department visits and improve clinical outcomes among older adults with chronic conditions. However, there is a lack of research on the impact of telehealth (TH) use on patient outcomes in post-acute rehabilitation settings. The current study examined the effects of TH for post-acute rehabilitation patient outcomes (i.e. discharge setting and change in functional independence) when controlling for other factors (e.g. cognitive functioning). Methods For this retrospective study, electronic medical records (EMRs) of 294 patients who were discharged from a post-acute rehabilitation unit at a skilled nursing facility were reviewed. Only patients with an admitting condition of a circulatory disease based on ICD-9 classification were included. Main EMR data extracted included use of TH, cognitive functioning, admission and discharge functional independence, and discharge setting (returning home vs. returning to acute care/re-hospitalisation). Results Results from a regression analysis showed that although TH use was unrelated to post-acute rehabilitation care transition, it was significantly related to change in functional independence. Patients who used TH during their stay had significantly more improvement in functional independence from admission to discharge when compared to those who did not use TH. Discussion Findings indicate that TH use during post-acute rehabilitation has the potential to improve patient physical functioning.

Leisure Activity Engagement and Positive Affect Partially Mediate the Relationship Between Positive Views on Aging and Physical Health.

OBJECTIVES.: To examine leisure activity engagement and positive affect as potential mediators for the relationships between positive views on aging (PVA) and two health outcomes: subjective health and physical limitations. METHOD.: Data from 5,194 participants from the German Ageing Survey (aged 40-91 years) were used to examine relationships between PVA to subjective health (assessed by self-rated health and perceived health change from past) and physical limitations (assessed via self-reported limitations on 10 activities). Leisure activity engagement and positive affect were examined as potential mediators in latent variable path analyses. Age moderation among these relationships was also examined. RESULTS.: Leisure activity engagement and positive affect separately and jointly served to partially mediate the relationships between PVA and the health outcomes. When entered as joint mediators, positive affect no longer significantly predicted physical limitations, indicating a shared variance with leisure activity engagement. Age moderated the relationship between PVA and physical limitations; the relationship was stronger among older adults than among middle-aged adults. DISCUSSION.: Leisure activity engagement and positive affect were shown to help explain the relationship between PVA and health, but differently for different health constructs and also among middle-aged and older adults. Findings provide further insight into ways in which PVA influence health.