Résumé :
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[BDSP. Notice produite par INIST 4QR0x2DT. Diffusion soumise à autorisation]. Context Comprehensive discharge planning by advanced practice nurses has demonstrated short-term reductions in readmissions of elderly patients, but the benefits of more intensive follow-up of hospitalized elders at risk for poor outcomes after discharge has not been studied. Objective To examine the effectiveness of an advanced practice nurse-centered discharge planning and home follow-up intervention for elders at risk for hospital readmissions. Design Randomized clinical trial with follow-up at 2,6,12, and 24 weeks after index hospital discharge. Setting Two urban, academically affiliated hospitals in Philadelphia, Pa. Participants Eligible patients were 65 years or older, hospitalized between August 1992 and March 1996, and had 1 of several medical and surgical reasons for admission. Intervention Intervention group patients received a comprehensive discharge planning and home follow-up protocol designed specifically for elders at risk for poor out-h comes after discharge and implemented by advanced practice nurses. Main Outcome Measures Readmissions, time to first readmission, acute care visits after discharge, costs, functional status, depression, and patient satisfaction. Results A total of 363 patients (186 in the control group and 177 in the intervention group) were enrolled in the study ; 70% of intervention and 74% of control subjects completed the trial. Mean age of sample was 75 years ; 50% were men and 45% were black. (...)
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