Effect of the Elderly Transitional Care Program in COVID-19 pandemic on 30 - days hospital readmission and ER visit

Abstract

        This study was quasi-experimental research, using a two – group, pre-test/post-test design. The aim was to evaluate the effects of the Elderly Transitional Care Program in COVID-19 pandemic on 30 - days hospital readmission and ER visit. The samples were 42 elderly persons with high risk for readmission in Inpatient Pathumrat hospital. The intervention group included 21 patients that used the Transitional Care Program (TCP) and a control group included 21 patients without using the program.   The primary outcomes were 30 - days hospital readmission or ER visit after discharge from the hospital. The secondary outcomes were within-group changes in Activities of Daily Living (ADL). Patients underwent two study visits, one at baseline and one at 30 days post baseline. Research instruments were composed of the transitional care program. The data collection tools included comprehensive geriatric assessment form including Activities of Daily Living questionnaire, Elder Risk Assessment scores, home visit tracking record, Post discharge follow up phone call documentation and readmission records. The primary analysis included readmission rate from baseline to rehospitalization or ER visit. Data were analyzed using descriptive and inferential statistics, chi-square test, and t-test.

               The results showed that the readmission rate of the elderly patients after

receiving the transitional care program was significantly lower than that of the control group (9.52% compared with 38.10% for control group, c² = 4.73 p-value = 0.03). The secondary analysis showed some improvement in ADL but no differences. (p = 0.33)

Conclusion and recommendations: Based on this intervention, we found significant lower readmission rate in intervention group. However, the data leads us to recommend future studies with larger sample sizes for a long time and evaluate in nursing outcomes.