[Efficacy of nursing planning after hospital discharge of patients over 65 to reduce their readmission]. / Eficacia de la planificación del alta de enfermería para disminuir los reingresos en mayores de 65 años.

OBJECTIVES: To evaluate the efficacy of nursing care and monitoring of patients over 65 in primary care, to reduce the rate of readmission and to extend time till readmission. DESIGN: Non-randomised clinical trial with control. SETTING: Base Area 8, Madrid, Spain. Primary and specialist care. PARTICIPANTS: Patients over 65 admitted from home with the pathologies under study. There were 97 patients in the study, 49 in the intervention group and 48 in the control group. INTERVENTIONS: In the intervention group, link nursing conducted visits every 48 hours and provided health education to carer and patient. Patients in the control group received conventional care. Patients in both groups were contacted by phone by primary care nurses 2, 6, 12, and 24 weeks after their hospital discharge. MEASUREMENTS: Readmission for the same reason was recorded. As a secondary variable, time till readmission was recorded. RESULTS: Patients in the control group were admitted more often than those in the experimental group (OR, 3.3; 95% CI, 1.13-9.52; adjusted for the admission diagnosis). The result was consistent, on conducting an analysis of the time elapsed before readmission (HR, 2.29; 95% CI, 1.03-5.10; adjusted in the same way). CONCLUSIONS: A planned intervention into discharges with full, individual evaluation reduces readmissions and increases the time till readmission in patients over 65.

Eficacia de la planificación del alta de enfermería para disminuir los reingresos en mayores de 65 años / Efficacy of nursing planning after hospital discharge of patients over 65 to reduce their readmission

Objetivos. Evaluar la eficacia de la planificación del alta y seguimiento en atención primaria de pacientes mayores de 65 años, para disminuir la tasa de reingresos y la reducción del tiempo hasta el reingreso. Diseño. Ensayo clínico controlado, no aleatorizado. Emplazamiento. Área Sanitaria 8 de Madrid. Participantes. Mayores de 65 años que ingresaran procedentes de sus domicilios con las patologías de estudio. Participaron en el estudio 97 pacientes, 49 en el grupo intervención y 48 en el grupo control. Intervenciones. El personal de enfermería de enlace realizaba visitas cada 48 horas y proporcionaba educación sanitaria al cuidador y al paciente. Los pacientes en el grupo control recibieron la atención convencional. El personal de enfermería de atención primaria contactó telefónicamente con los pacientes de ambos grupos a las 2, 6, 12 y 24 semanas después de su alta hospitalaria. Mediciones. Se registró el reingreso por la misma causa y el tiempo hasta el reingreso. Resultados. Los pacientes del grupo control ingresaron con más frecuencia que los del grupo experimental (OR = 3,3; IC del 95%, 1,13-9,52; ajustado por el diagnóstico al ingreso). El resultado concordaba al realizar un análisis considerando el tiempo hasta el reingreso (HR = 2, 29; IC del 95%, 1,03-5,10; ajustando de la misma manera). Conclusiones. Una intervención planificada del alta con una valoración integral individualizada disminuye los reingresos y el tiempo hasta el reingreso en mayores de 65 años

Objectives. To evaluate the efficacy of nursing care and monitoring of patients over 65 in primary care, to reduce the rate of readmission and to extend time till readmission. Design. Non-randomised clinical trial with control. Setting. Base Area 8, Madrid, Spain. Primary and specialist care. Participants. Patients over 65 admitted from home with the pathologies under study. There were 97 patients in the study, 49 in the intervention group and 48 in the control group. Interventions. In the intervention group, link nursing conducted visits every 48 hours and provided health education to carer and patient. Patients in the control group received conventional care. Patients in both groups were contacted by phone by primary care nurses 2, 6, 12, and 24 weeks after their hospital discharge. Measurements. Readmission for the same reason was recorded. As a secondary variable, time till readmission was recorded. Results. Patients in the control group were admitted more often than those in the experimental group (OR, 3.3; 95% CI, 1.13-9.52; adjusted for the admission diagnosis). The result was consistent, on conducting an analysis of the time elapsed before readmission (HR, 2.29; 95% CI, 1.03-5.10; adjusted in the same way). Conclusions. A planned intervention into discharges with full, individual evaluation reduces readmissions and increases the time till readmission in patients over 65