Early geriatric follow-up visits to nursing home residents reduce the number of readmissions: a quasi-randomised controlled trial.

Abstract

Nursing home residents have a high risk of being readmitted after hospitalisation. The objective of this study is to test whether an early geriatric follow-up visit can reduce readmissions among nursing home residents without increasing mortality. The main components of the intervention will also be quantified. A quasi-randomised controlled design. A population of nursing-home residents aged 75years or older admitted to hospital with one of nine medical diagnoses. All patients received comprehensive geriatric assessment before discharge. The intervention comprised a visit by a nurse and a doctor from a geriatric team the first weekday after discharge. Control group patients were offered a follow-up visit by their general practitioner 7-14days after discharge. Six hundred and forty-eight patients were included in the study between June 1st 2014 and December 15th 2016. In the intervention group, 13% were readmitted within 30days after discharge, compared to 19% in the control group (p=0.04). Adjusted hazard ratio=0.63 (95% CI 0.42-0.95). The median length of hospital stay was 1day for both groups. Neither 30 nor 90-day mortality were affected by the intervention. The most commonly registered intervention element was direct person-to-person contact between hospital and nursing home staff or relatives, followed by changes in medication and blood tests. Early geriatric follow-up visits to recently discharged nursing home residents are a safe and effective way of reducing readmissions. Communication, changes in medication, and blood tests were the most frequently performed elements.