Risk of Rehospitalization or Emergency Department Visit is Significantly Higher for Patients who Receive Their First Home Health Care Nursing Visit Later than 2 Days After Hospital Discharge.
Maxim Topaz, Yolanda Barrón, Jiyoun Song and 7 others
PMID 35931136WHAT IT FOUND
Home health nursing visits begun more than 2 days after hospital discharge were associated with higher 30-day rehospitalization or emergency department visits: 15.8% versus 12.5%.
Accounting for other factors, delayed visits had 12% higher odds.
Key findings
01Delayed start-of-care nursing visits were associated with a higher 30-day rehospitalization or ED visit rate: 15.8% versus 12.5%.
02After adjustment, start-of-care nursing visit timing greater than 2 days was associated with 12% increased odds of 30-day rehospitalization or ED visit (OR 1.12; 95% CI: 1.06 to 1.18).
03Delayed start-of-care nursing visits occurred in 34% of episodes, and 14% of episodes had a 30-day rehospitalization or ED visit.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done in one large urban home health agency, so the findings may not apply to other agencies or patient populations. This was an observational study, so it shows association rather than proof that delaying the nursing visit caused rehospitalization or emergency department use. Hospitalizations and emergency visits were taken from OASIS, which may miss events unknown to the home health clinician or events occurring after home health discharge within the 30-day window. The outcome combined rehospitalization and emergency department visits, so it does not separate those two events. 1.3% of episodes were excluded from the adjusted model because of missing values.
Declared interests
The paper is tagged as supported by NIH extramural research; the supplied text does not report author conflicts of interest.
The easy way to misread this
Do not conclude that making the first nursing visit within 2 days will prevent rehospitalization or emergency department visits. This was an observational association, not a randomized test, and the outcome data may have missed some events.