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Home telehealth and hospital readmissions: a retrospective OASIS-C data analysis
Tanna R Thomason1, Shelley Y Hawkins, Katherine E Perkins
1Tanna R. Thomason, MS, RN-BC, CNS, CCRN, PCCN, is a PhD Student, Hahn School of Nursing and Health Science, University of San Diego, San Diego, California. Shelley Y. Hawkins, PhD, FNP-BC, GNP, FAANP, is an Associate Professor and Director, DNP & MSN NP Programs, Hahn School of Nursing and Health Science, University of San Diego, San Diego, California. Katherine E. Perkins, BAN, RN, is a Quality Nurse Manager, Palomar Home Health Services, Escondido, California. Elissa Hamilton, BSN, MBA, NE-BC, is the Director, Palomar Home Health Services, Escondido, California. Betty Nelson, BSN, RN, is a CAHSAH-certified Manager, Palomar Home Health Services, Escondido, California.
Abstract:
Technology holds potential to improve the quality of healthcare delivery. The use of remote patient monitoring, or telehealth (TH), has been widely adopted by many home care agencies to facilitate early identification of disease exacerbation, particularly for patients with chronic diseases such as heart failure. TH has been successfully used to improve symptom detection and potentially reduce rehospitalization rates. Quantifying program effectiveness through data analysis is a critical step for program improvement, resource allocation, and future strategic planning. Using the Outcome and Assessment Information Set-C database, a retrospective analysis was conducted examining 22 months of heart failure patient data from one home care agency in southern California. Seventy patients receiving TH were compared to patients who received usual home care nursing services. No major differences in baseline socio-demographics were found between the 2 groups. While receiving home healthcare services, the non-TH patients had a 21% all-cause hospital readmission rate, compared to the home TH patients with a 10% all-cause readmission rate. Statistical differences were found between groups on the variables of fall risk, vision, smoking, shortness of breath, the ability to bathe and take oral meds, along with having been discharged from a skilled nursing facility in the last 2 weeks. These results indicate that aggregate data analysis is useful in providing insight into program effectiveness. This study suggests TH programs have the potential to reduce the burden associated with rehospitalizations in the heart failure population.
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