Association Between Nursing Visits and Hospital-Related Disenrollment in the Home Hospice Population.
Veerawat Phongtankuel, Ronald D Adelman, Kelly Trevino and 5 others
PMID 28285542WHAT IT FOUND
Home hospice patients receiving 3 or more nursing visits per week had significantly lower odds of hospital-related disenrollment compared to those with fewer visits.
The effect strengthened with higher visit frequencies, suggesting increased nurse contact may help keep patients at home.
Key findings
01Enrollments with 3 or more average nursing visits per week had significantly lower odds of hospital-related disenrollment compared to those with fewer than 3 visits.
02In multivariable analysis, the odds of hospital-related disenrollment decreased as nursing visit frequency increased, with 5+ visits per week associated with the lowest odds.
03Use of continuous home care and general inpatient care was associated with lower odds of hospital-related disenrollment, but respite care was not.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used claims data, which may under-report nursing visits if codes were not entered correctly. Patients with multiple hospice diagnoses were excluded, which may have selected for a healthier group. The analysis used average visits per week, which does not account for fluctuations in care intensity during crises. The study could not distinguish between different types of nursing care or determine if visits caused the reduction in disenrollment or were simply a response to higher risk. Hospital transitions that did not result in disenrollment were not captured.
Declared interests
The authors declared no potential conflicts of interest.
The easy way to misread this
Do not assume that simply scheduling more nursing visits will prevent hospitalization. This is an observational study showing an association, not causation. Patients who receive more visits may differ in ways not fully captured by the data, such as having more complex needs that are better managed with frequent contact, or conversely, being at higher risk of transition. The finding suggests a correlation that warrants further investigation into the mechanisms of care, rather than a direct prescription for visit frequency.