The Impact of Early Involvement in a Postdischarge Support Program for Ostomy Surgery Patients on Preventable Healthcare Utilization.
Sirikan Rojanasarot
PMID 29189646WHAT IT FOUND
During the first month, ostomy patients in a support program looked similar to comparison patients after accounting for patient and care differences.
After the first month, enrollees reported fewer readmissions and emergency visits.
Key findings
01After the first month, program enrollees reported fewer ostomy-related hospital readmissions (16% vs 24%) and fewer emergency visits (12% vs 21%) than comparison respondents.
02During the first month, enrollees reported fewer readmissions (17% vs 25%), but after accounting for patient and care factors, readmission and emergency visit odds did not differ significantly.
03Using the American College of Surgeons Ostomy Home Skills kit was associated with lower adjusted odds of readmission and emergency visits in both periods.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a cross-sectional survey, so it can show associations but not prove the program caused fewer readmissions or emergency visits. Response rates were low (7% of invited program enrollees and 5% of comparison individuals), so respondents may not represent all ostomy patients. Outcomes were patient-reported, and some events could have been forgotten or misclassified. Program enrollees differed from comparison respondents: they were more likely to be younger, have at least a bachelor's degree, and use the ACS kit, so selection and unmeasured differences may explain part of the association. The support program included several components, including advisor contact, product samples and a travel kit, and wellness education, so the effect of any single component cannot be separated.
Declared interests
No funding or conflict-of-interest declaration is provided in the supplied text. The survey used a database maintained by the ostomy support program provider, Coloplast, and product-specific advice was limited to that provider's products.
The easy way to misread this
Do not conclude that the support program caused fewer readmissions or emergency visits. This was a cross-sectional survey with low response rates, self-selected enrollees, patient-reported outcomes, and multiple program components, so it can show association but not causation or which component mattered.