Post-acute care for frail older people decreases 90-day emergency room visits, readmissions and mortality: An interventional study.
<h4>Background</h4>To evaluate the effects of post-acute care (PAC) on frail older adults after acute hospitalization in Taiwan.<h4>Methods</h4>This was a multicenter interventional study. Frail patients aged ≥ 75 were recruited and divided into PAC or control group. The PAC...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2023-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0279654 |
| _version_ | 1797866813970710528 |
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| author | Min-Chang Lee Tai-Yin Wu Sheng-Jean Huang Ya-Mei Chen Sheng-Huang Hsiao Ching-Yao Tsai |
| author_facet | Min-Chang Lee Tai-Yin Wu Sheng-Jean Huang Ya-Mei Chen Sheng-Huang Hsiao Ching-Yao Tsai |
| author_sort | Min-Chang Lee |
| collection | DOAJ |
| description | <h4>Background</h4>To evaluate the effects of post-acute care (PAC) on frail older adults after acute hospitalization in Taiwan.<h4>Methods</h4>This was a multicenter interventional study. Frail patients aged ≥ 75 were recruited and divided into PAC or control group. The PAC group received comprehensive geriatric assessment (CGA) and multifactorial intervention including exercise, nutrition education, and medicinal adjustments for two to four weeks, while the control group received only CGA. Outcome measures included emergency room (ER) visits, readmissions, and mortality within 90 days after PAC.<h4>Results</h4>Among 254 participants, 205 (87.6±6.0 years) were in the PAC and 49 (85.2±6.0 years) in the control group. PAC for more than two weeks significantly decreased 90-day ER visits (odds ratio [OR] 0.21, 95% confidence interval [CI] 0.10-0.43; p = 0.024), readmissions (OR 0.30, 95% CI 0.16-0.56; p < 0.001), and mortality (OR 0.20, 95% CI 0.04-0.87; p = 0.032). Having problems in self-care was an independent risk factor for 90-day ER visits (OR 2.11, 95% CI 1.17-3.78; p = 0.012), and having problems in usual activities was an independent risk factor for 90-day readmissions (OR 2.69, 95% CI 1.53-4.72; p = 0.001) and mortality (OR 3.16, 95% CI 1.16-8.63; p = 0.024).<h4>Conclusion</h4>PAC program for more than two weeks could have beneficial effects on decreasing ER visits, readmissions, and mortality after an acute illness in frail older patients. Those who perceived severe problems in self-care and usual activities had a higher risk of subsequent adverse outcomes.<h4>Trial registration</h4>ClinicalTrials.gov NCT Identifier: NCT05452395. |
| first_indexed | 2024-04-09T23:31:23Z |
| format | Article |
| id | doaj.art-fbcfcfc6514b47da94058bb7d68e1a98 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-09T23:31:23Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj.art-fbcfcfc6514b47da94058bb7d68e1a982023-03-21T05:31:49ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01181e027965410.1371/journal.pone.0279654Post-acute care for frail older people decreases 90-day emergency room visits, readmissions and mortality: An interventional study.Min-Chang LeeTai-Yin WuSheng-Jean HuangYa-Mei ChenSheng-Huang HsiaoChing-Yao Tsai<h4>Background</h4>To evaluate the effects of post-acute care (PAC) on frail older adults after acute hospitalization in Taiwan.<h4>Methods</h4>This was a multicenter interventional study. Frail patients aged ≥ 75 were recruited and divided into PAC or control group. The PAC group received comprehensive geriatric assessment (CGA) and multifactorial intervention including exercise, nutrition education, and medicinal adjustments for two to four weeks, while the control group received only CGA. Outcome measures included emergency room (ER) visits, readmissions, and mortality within 90 days after PAC.<h4>Results</h4>Among 254 participants, 205 (87.6±6.0 years) were in the PAC and 49 (85.2±6.0 years) in the control group. PAC for more than two weeks significantly decreased 90-day ER visits (odds ratio [OR] 0.21, 95% confidence interval [CI] 0.10-0.43; p = 0.024), readmissions (OR 0.30, 95% CI 0.16-0.56; p < 0.001), and mortality (OR 0.20, 95% CI 0.04-0.87; p = 0.032). Having problems in self-care was an independent risk factor for 90-day ER visits (OR 2.11, 95% CI 1.17-3.78; p = 0.012), and having problems in usual activities was an independent risk factor for 90-day readmissions (OR 2.69, 95% CI 1.53-4.72; p = 0.001) and mortality (OR 3.16, 95% CI 1.16-8.63; p = 0.024).<h4>Conclusion</h4>PAC program for more than two weeks could have beneficial effects on decreasing ER visits, readmissions, and mortality after an acute illness in frail older patients. Those who perceived severe problems in self-care and usual activities had a higher risk of subsequent adverse outcomes.<h4>Trial registration</h4>ClinicalTrials.gov NCT Identifier: NCT05452395.https://doi.org/10.1371/journal.pone.0279654 |
| spellingShingle | Min-Chang Lee Tai-Yin Wu Sheng-Jean Huang Ya-Mei Chen Sheng-Huang Hsiao Ching-Yao Tsai Post-acute care for frail older people decreases 90-day emergency room visits, readmissions and mortality: An interventional study. PLoS ONE |
| title | Post-acute care for frail older people decreases 90-day emergency room visits, readmissions and mortality: An interventional study. |
| title_full | Post-acute care for frail older people decreases 90-day emergency room visits, readmissions and mortality: An interventional study. |
| title_fullStr | Post-acute care for frail older people decreases 90-day emergency room visits, readmissions and mortality: An interventional study. |
| title_full_unstemmed | Post-acute care for frail older people decreases 90-day emergency room visits, readmissions and mortality: An interventional study. |
| title_short | Post-acute care for frail older people decreases 90-day emergency room visits, readmissions and mortality: An interventional study. |
| title_sort | post acute care for frail older people decreases 90 day emergency room visits readmissions and mortality an interventional study |
| url | https://doi.org/10.1371/journal.pone.0279654 |
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