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Berlin Brandenburg

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  • 1
    In: Medical Care, 1988, Vol.26(7), pp.699-708
    Description: A multifaceted intervention was hypothesized to increase postdischarge ambulatory contacts and to reduce nonelective readmissions. Patients (N=1,001) discharged from the general medicine service were stratified by risk for nonelective readmission and randomized to the control or intervention group. Intervention patients received phone calls from nurses, mailings of appointment reminders and lists of early warning signs, and prompt rescheduling of visit failures. Patients were followed for 6 months, and the results were computed in units per patient per month. The intervention group had 10.4% more total office contacts (0.53 vs 0.48, P=0.005) than the control group. Although the intervention group had 7.6% fewer nonelective readmission days (0.85 vs 0.92), this was not statistically significant (P=0.5). Patients in the intervention group at high risk (N=181) had 28.1% more office visits (0.73 vs 0.57, P〈0.01) and 31.9% fewer nonelective readmission days (1.13 vs 1.66), but this was also not statistically significant (P=0.06). Thus, the intervention significantly increased postdischarge contacts, primarily in high-risk patients, but failed to reduce the incidence of nonelective readmission days significantly.
    Keywords: Aftercare ; Patient Readmission;
    ISSN: 0025-7079
    E-ISSN: 15371948
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  • 2
    In: Medical Care, 1986, Vol.24(3), pp.189-199
    Description: Patients who fail to show for scheduled visits or who fail to contact their provider when warning symptoms occur pose important problems for the primary care physician. A group of interventions was examined to determine the effectiveness in increasing the number of prescribed office visits in patients with diabetes mellitus. This group of interventions included mailed packets with information on how to use the clinic, providersʼ names and phone numbers, after-hours phone numbers, a list of early warning signs, and a booklet on managing diabetes mellitus; mailed appointment reminders; and intense followup of visit failures for prompt rescheduling. Eight hundred fifty-nine patients on drug therapy for diabetes mellitus were stratified by risk of hospitalization and randomly assigned within strata to control and intervention groups. The intervention group received all interventions. After 1 year, the intervention group averaged 12% more total contacts than the control group (5.8 vs. 5.2, P = 0.01), due largely to an increase in kept scheduled visits (4.1 vs. 3.6, P = 0.006). These effects were greatest in those patients at higher risk of hospitalization. Also, visit failures were reduced only in high-risk patients. The effect of the interventions did not diminish during the year of study. This systematic and repetitive intervention appears effective in increasing prescribed office visits and is especially effective in patients requiring more frequent care.
    Keywords: Medicine ; Public Health;
    ISSN: 0025-7079
    E-ISSN: 15371948
    Library Location Call Number Volume/Issue/Year Availability
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