OBJECTIVES: To compare the effects of nurse case management with usual care provided to community-dwelling frail older people in regard to quality of life, satisfaction with care, functional status, admission to hospital, length of hospital stay, and readmission to emergency department. DESIGN: Randomized controlled trial. SETTING:University hospital and two proximal community health centers. PARTICIPANTS: 427 frail older people (> or = 70 years of age and at risk for repeated hospital admissions) discharged home from the emergency department. EXPERIMENTAL: Nurse case management, which consisted of coordination and provision of healthcare services by nurses, both in and out of hospital, for a 10-month period. CONTROL: Usual care, which varied by healthcare provider and community health center. MEASUREMENTS: Outcomes were assessed 10 months post-randomization by telephone and/or home interview and by medical record review. Questionnaires included the SF-36, CSQ-8, and OARS. RESULTS: No significant differences were found in quality of life, satisfaction with care, functional status, admission to hospital, or length of hospital stay. Nurse-case-managed older adults were readmitted to the emergency department significantly more often than their usual care counterparts. CONCLUSIONS:Frail older people receiving nurse case management are more likely to use emergency health services without a concomitant increase in health benefits.
RCT Entities:
OBJECTIVES: To compare the effects of nurse case management with usual care provided to community-dwelling frail older people in regard to quality of life, satisfaction with care, functional status, admission to hospital, length of hospital stay, and readmission to emergency department. DESIGN: Randomized controlled trial. SETTING: University hospital and two proximal community health centers. PARTICIPANTS: 427 frail older people (> or = 70 years of age and at risk for repeated hospital admissions) discharged home from the emergency department. EXPERIMENTAL: Nurse case management, which consisted of coordination and provision of healthcare services by nurses, both in and out of hospital, for a 10-month period. CONTROL: Usual care, which varied by healthcare provider and community health center. MEASUREMENTS: Outcomes were assessed 10 months post-randomization by telephone and/or home interview and by medical record review. Questionnaires included the SF-36, CSQ-8, and OARS. RESULTS: No significant differences were found in quality of life, satisfaction with care, functional status, admission to hospital, or length of hospital stay. Nurse-case-managed older adults were readmitted to the emergency department significantly more often than their usual care counterparts. CONCLUSIONS: Frail older people receiving nurse case management are more likely to use emergency health services without a concomitant increase in health benefits.
Authors: Susan N Hastings; Karen M Stechuchak; Cynthia J Coffman; Elizabeth P Mahanna; Morris Weinberger; Courtney H Van Houtven; Kenneth E Schmader; Cristina C Hendrix; Chad Kessler; Jaime M Hughes; Katherine Ramos; G Darryl Wieland; Madeline Weiner; Katina Robinson; Eugene Oddone Journal: J Gen Intern Med Date: 2019-09-05 Impact factor: 5.128
Authors: Masha G Jones; Katherine A Ornstein; David M Skovran; Theresa A Soriano; Linda V DeCherrie Journal: Geriatr Nurs Date: 2016-11-19 Impact factor: 2.361