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Effects of alternative interventions among hospitalized, cognitively impaired older adults
Mary D Naylor1,2, Karen B Hirschman1,2, Alexandra L Hanlon1,2
1New Courtland Center for Transitions & Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
Aim:
Compare within site effects of three interventions designed to enhance outcomes of hospitalized cognitively impaired elders.
Methods:
Prospective, nonrandomized, confirmatory phased study. In Phase I, 183 patients received one of three interventions: augmented standard care (ASC), resource nurse care (RNC) or Transitional Care Model (TCM). In Phase II, 205 patients received the TCM.
Results:
Time to first rehospitalization or death was longer for the TCM versus ASC group (p = 0.017). Rates for total all-cause rehospitalizations and days were significantly reduced in the TCM versus ASC group (p < 0.001, both). No differences were observed between RNC versus TCM.
Conclusion:
Findings suggest the TCM is more effective than ASC. However, potential effects of the RNC relative to the TCM warrant further study.
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