Young-Rock Hong1, Michelle Cardel2, Ryan Suk3, Ivana A Vaughn4, Ashish A Deshmukh3, Carla L Fisher5,6, Gregory Pavela7, Kalyani Sonawane3. 1. Department of Health Services Research, Management and Policy in the College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA. youngrock.h@phhp.ufl.edu. 2. Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA. 3. Department of Management, Policy and Community Health, The University of Texas Health Science Center, Houston, TX, USA. 4. Center for Evaluation and Applied Research, The New York Academy of Medicine, New York, NY, USA. 5. Department of Advertising, College of Journalism and Communications, University of Florida, Gainesville, FL, USA. 6. UF Health Cancer Center, Center for Arts in Medicine, STEM Translational Communication Center, University of Florida, Gainesville, FL, USA. 7. Department of Health Behavior, School of Public Health University of Alabama, Birmingham, AL, USA.
Abstract
BACKGROUND: The teach-back method, also known as the "show-me" method, has been endorsed by many medical and health care societies. However, limited investigation has been conducted regarding its association with patient outcomes. OBJECTIVES: To examine the association between patient teach-back experience and the risk of hospitalizations and length of hospital stay among patients with ambulatory care sensitive conditions (ACSCs). DESIGN: A matched cohort study. SETTING: Data from the 2011-2015 Longitudinal Medical Expenditure Panel Survey (panels 16-19). PARTICIPANTS: Three thousand nine hundred ninety-four US adults aged ≥ 18 years with any of 5 ACSCs (hypertension, type 2 diabetes, heart disease, asthma, and chronic obstructive pulmonary disease [COPD]). MEASUREMENTS: Hospital admissions (all-cause or ACSC-related) and the length of stay of the first admission were examined by teach-back during interaction with a health provider. RESULTS: Patients with teach-back experience were less likely to experience hospitalization for an ACSC-related condition (relative risk, 0.85; 95% CI, 0.71 to 0.99) and had a lower risk for a condition-related readmission (hazard ratio, 0.77; 95% CI, 0.60 to 0.99), compared with those without teach-back experience. The median length of hospital stay did not differ between patients with teach-back experience and those without teach-back experience (median 3 days [IQR 1 to 8 days] and median 3 days [IQR 0 to 8 days], respectively; P = 0.84). Subgroup analysis showed that the association of reported teach-back experience on the outcomes was relatively stable among those with hypertension, diabetes, and heart disease, but was not among those with asthma or COPD. LIMITATION: Teach-back exposure relied on patient self-reported information. CONCLUSIONS: Our findings suggest that patient teach-back method is associated with reduced risk of hospitalization for those with ACSCs, especially among patients with cardiovascular diseases and type 2 diabetes. Encouraging providers to utilize the teach-back method at every visit has the potential to further reduce hospitalizations for individuals with ACSCs.
BACKGROUND: The teach-back method, also known as the "show-me" method, has been endorsed by many medical and health care societies. However, limited investigation has been conducted regarding its association with patient outcomes. OBJECTIVES: To examine the association between patient teach-back experience and the risk of hospitalizations and length of hospital stay among patients with ambulatory care sensitive conditions (ACSCs). DESIGN: A matched cohort study. SETTING: Data from the 2011-2015 Longitudinal Medical Expenditure Panel Survey (panels 16-19). PARTICIPANTS: Three thousand nine hundred ninety-four US adults aged ≥ 18 years with any of 5 ACSCs (hypertension, type 2 diabetes, heart disease, asthma, and chronic obstructive pulmonary disease [COPD]). MEASUREMENTS: Hospital admissions (all-cause or ACSC-related) and the length of stay of the first admission were examined by teach-back during interaction with a health provider. RESULTS:Patients with teach-back experience were less likely to experience hospitalization for an ACSC-related condition (relative risk, 0.85; 95% CI, 0.71 to 0.99) and had a lower risk for a condition-related readmission (hazard ratio, 0.77; 95% CI, 0.60 to 0.99), compared with those without teach-back experience. The median length of hospital stay did not differ between patients with teach-back experience and those without teach-back experience (median 3 days [IQR 1 to 8 days] and median 3 days [IQR 0 to 8 days], respectively; P = 0.84). Subgroup analysis showed that the association of reported teach-back experience on the outcomes was relatively stable among those with hypertension, diabetes, and heart disease, but was not among those with asthma or COPD. LIMITATION: Teach-back exposure relied on patient self-reported information. CONCLUSIONS: Our findings suggest that patient teach-back method is associated with reduced risk of hospitalization for those with ACSCs, especially among patients with cardiovascular diseases and type 2 diabetes. Encouraging providers to utilize the teach-back method at every visit has the potential to further reduce hospitalizations for individuals with ACSCs.
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