Abstract

Using an integrated model, the Donabedian Quality and Logic Model, we examined a remote monitoring heart failure disease management program. This quantitative research used post-test only case matched design. The sample consisted of 210 participants from 23 home health care agencies. Logistic regression results indicated statistical significance, there was an inverse relationship between caregiver support and the complexity of decision making; X2 (3, n = 210) = 29.984, P = 0.012. The DTreg suggested that participants who were advised to go to the ER had a 1.00 probability of doing so, and those who were instructed otherwise had a 0.37 probability of going to the ER. Among participants who experienced a hospital readmission, there was 0.50 probability that patient education or other clinical intervention was implemented prior to the admission. As home health care agencies consider disease management programs, it is important to gain a comprehensive understanding of the potential of innovative programs and the resources they require. While the agency invested the resources required by the remote monitoring program, the study demonstrated that caregiver support was a critical structural component of the program and may affect change in nurses' decision making to mitigate hospital utilization. We recommend that home health care agencies take greater consideration of the family and social support in implementing a remote monitoring system.

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