期刊
SOCIAL SCIENCE & MEDICINE
卷 73, 期 7, 页码 960-969出版社
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.socscimed.2011.06.036
关键词
Health-social partnership; Hospital readmission; Transitional care; Quality of life; Self efficacy; Nurse case management; China; Hong Kong
资金
- Hong Kong Jockey Club Charities Trust [5ZH60]
- HK SKH Wong Tai Sin District Elderly Community Center
- HK SKH Chuk Yuen Canon Martin District Elderly Community Centre
- HK SKH Lok Man Alice Kwok Integrated Service Center
- Salvation Army Yaumatei Multi-service Center for Senior Citizens
- Salvation Army Chuk Yuen Integrated Services
- SKH Holy Carpenter Church District Elderly Community Centre
- Mong Kok Kai Fong Association Ltd.
- Chan Hing Social Service Centre
Hospital readmission is an indicator of care quality. Studies have been conducted to test whether post-discharge transitional care programs can reduce hospital readmission, but results are not conclusive. The contemporary development of post-discharge support advocates a health and social partnership approach. There is a paucity of experimental studies examining the effects of such efforts. This study designed a health-social transitional care management program (HSTCMP) and subjected it to empirical testing using a randomized controlled trial in the medical units of an acute general hospital with 1700 beds in Hong Kong during the period of February 2009 to July 2010. Results using per-protocol analysis revealed that the HSTCMP significantly reduced readmission at 4-weeks (study 4.0%, control 10.2%, chi(2) = 7.98, p = 0.005). The intention-to-treat result also showed a lower readmission rate with the study group but the result was not significant (study 11.5%, control 14.7%, chi(2) = 1.53, p = 0.258). There was however significant improvement in quality of life, self-efficacy and satisfaction in the study group in both per-protocol and intention-to-treat analyses. The study suggests that a health-social partnership, using volunteers as substitutes for some of the professional care, may be effective for general medical patients. (C) 2011 Elsevier Ltd. All rights reserved.
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