Post Discharge Care and Hospital Readmission - Article Example

Post Discharge Care and Hospital Readmission I. Congestive heart failure is a condition that presents a significant medical challenge in the treatment and management as well. While medication might be availed to the patients in most cases hospitalization remains inevitable. Because of the complexity of the care required for the management of the conditions, post-acute care has become a fundamental part of the process of presenting comprehensive care to patients. This article presents a meta-analysis of various publications seeking to identify the effectiveness of the post-acute care interventions in prevention of readmission to hospitals. An evaluation of the methods is used to determine the methods which can be employed to improve the management of the condition and prevent readmission. II. Table of Contents I. Abstract 1 III. Introduction 3 IV. Statement of the Problem 3 a. Objectives of the study 4 b. Research questions 4 V. Literature review 4 VI. Methodology 6 a. Research design 6 b. Target population 6 c. Sampling 7 d. Data collection 7 d. Data analysis 8 III. Introduction Congestive heart failure is a draining ailment with an increasing prevalence in various sections and regions of the world especially among the elderly people. This illness is one of the major causes of hospital admission in various health care facilities around the globe (Khatibzadeh et al, 2013). The treatment cost that is associated with this condition is approximated to be $ 20 billion. Medical therapy for the condition has ensured that the survival rates have been increased. However, beneficial effect on the quality of lives of patients has not been widely reported. Up to 20% of patients with congestive heart failure are normally readmitted to the hospitals and health facilities within thirty days of discharge (Lloyd-Jones et al., 2005). This number or rate of readmission however varies region wisely and is also dependent on the insurance coverage that each of these patients have. These costs of readmission have necessitated the assessment of the various conditions that present a risk of admission and interventions have been developed to prevent readmission. IV. Statement of the Problem The prevalence of congestive heart failure diseases around the world presents a fundamental challenge to the healthcare system. Many patients suffering from this condition have to be placed under acute care within the hospitals, and this does not always end the problem (Calvillo–King et al., 2013). Once the patient conditions improve, discharge becomes imminent and the lack of proper care after discharge leads to readmission of the patients. This research seeks to identify the effectiveness of the post-acute care interventions in the prevention of hospital readmission. These interventions have mainly been adopted and implemented in seeking to ensure the patients receive comprehensive care and are not readmitted once they are discharged. This will be important in understanding the types of intervention s which are effective in the management of the condition outside the hospital setting a. Objectives of the study The study will be based on the following objectives To determine the effectiveness of different post-acute care interventions in the reduction of hospital readmission among patients with congestive heart failure To establish the most effective interventions in the management of congestive heart failure outside the hospital setting b. Research questions The findings of the research will seek to answer the following questions How effective are post-acute care interventions in reducing hospital readmissions among patients with congestive heart failure? Which is the most effective intervention in the management of congestive heart failure outside the hospital environment? V. Literature review Congestive heart failure is one of the conditions that present the significant challenge to the healthcare professionals owing to the large number of admissions. Globally, the disease affects individuals of different age groups and the focus of healthcare remains on ensuring the presentation of a comprehensive care for the patients suffering from the condition (Khatibzadeh et al., 2013). The challenge of patients being readmitted after discharge has resulted in the development of various approaches that are aimed at extending the care presented to patients within their homes. These interventions are mainly aimed at reducing the possibility of a patient being readmitted. The interventions include post-acute care intervention as well as transitional interventions that are utilized in preparing the patient for the discharge from hospital. Transitional interventions are used within the hospital in preparing the patient for a discharge from the hospital. Transitional interventions commonly have the effect of ensuring the patient has a sufficient information and understand the challenges which they might face once they are discharged. Patient education is normally delivered by the healthcare professionals as a way of informing the patient about the challenges that they might be faced with once they are outside the hospital (Naylor et al., 2004). Combined with other transitional interventions like discharge planning, medical conciliation and appointment schedules, the patient is able to understand the existing difficulties for management of the chronic condition of congestive heart failure. While the transitional interventions are offered within the hospital, post-acute care interventions are provided to the patient in seeking to reduce the possibility of the patient getting readmitted to the hospital. These are performed from the residence of the patients by the health care professional. They are normally follow-up medical services conducted to reduce readmission. They normally seeks to ensure that the patient continue to undertake and follow the instructions provided in the transitional interventions. The most popular interventions include planned clinics, home visits and outpatient management, which are provided to patients suffering from congestive heart failure. In most cases a combination of two or more of these post-acute care interventions is provided to patients in seeking to increase the effectiveness of the treatment administered. During clinic visits for example, patient education might also be provided to ensure the patient understand the problem better. Presence of current information pertaining the condition facing the patient becomes critical in increasing the understanding of the patient (Hansen et al, 2011). This information helps in the reduction of the social burden that patients and caregivers have with regard to the existing medical conditions, which is a chronic disease. The social environment within which the patients commonly reside commonly has some factors that could result in patients suffering from stress as a result of the chronic disease. These social factors are addressed during the post-acute care interventions which are provided to the patients (Calvillo–King et al., 2013). The effectiveness of the post-acute interventions therefore remains highly dependent on the various factors which are covered. Many of these interventions focus on the risk elements that might cause the patient to be hospitalized again, with the same problem which had been treated before. Such admissions have been thought as indications of the ineffectiveness of the healthcare system. VI. Methodology a. Research design The research is qualitative, seeking to evaluate whether post-acute care decreases the possibility of hospital readmission amongst patients who have congestive heart failure (Creswell, 2013). The research design which will be utilized will be a cohort study, as the study will be undertaken over a long period of time in order to understand the parameters which are being explored effectively. This type of design is most appropriate since other designs like the randomized control study would be unethical within this context. Observation of the information from a natural environment enhances the findings which are presented within the context of this research (Healy & Devane, 2011). This design will enable the researcher to be able to understand the causes and effects of some of the readmissions of hospital before they can occur. Both secondary and primary data will be used within the context of the research. The actual study however will only include primary data collected from the participants. b. Target population The target population for the research will be individuals of different ages who have suffered from congestive heart failures and been admitted to hospital in order to receive care. These individuals will be the focus of the research in seeking to determine the effectiveness of the specific post-acute care measures which are utilized and their effectiveness. These individuals will also provide information regarding any other factors which could have contributed to the readmission or failure for one to be readmitted. c. Sampling There are many challenges to finding participants in the study and this will mean that non-probability sampling procedures will be utilized within the research. an inclusions and exclusion technique will be employed to determine the participants who will be included within the research (Suri, 2011). While the research focuses on people who have been diagnosed with congestive heart failure, inclusion will be based on the willingness of the people to participate within the study. Exclusion will include people who might be below the age of 18 years, and whose inclusion would require having consent from a third party. Individuals suffering from a combination of medical conditions which might include congestive heart failure will not be included as the other medical conditions might affect the readmission. d. Data collection Primary data will be extensively utilized in the research and this will be conducted mainly through observation and interviews with the participants. Observation These will be conducted within the hospital in order to record the interventions which the patient has been subjected to. The researchers will take the details of the participants in order to be able to make follow-ups and record the data for analysis and presentation of the research findings. Medical records will also be used to provide the essential information as recorded by the professional. Interviews The patients’ perceptions will be understood interactive interviews with the participants. These interviews will be undertaken within any location based on the participants’ availability. This will in consideration of the medical condition of the participants some of whom might still fit enough. The interviews will be tape-recorded and transcribed at a later stage in the research process. The interviews will enable the researcher to gain a perception of the participants understanding of the interventions which are applied in post-acute care. d. Data analysis Upon the collection of the essential data analysis will be conducted through the utilization of qualitative methods which are considerate of any ethical issues within the research proposal. Since a lot of descriptive data will be available for the interviews and observations, descriptive statistics will be applied within the process of presenting and classifying the existing data (Tracy, 2013). Context sensitive analysis will be applied in placing information within various categories which enable the easy interpretation of collected information (Denzin & Lincoln, 2011). This will be critical in seeking to ensure the data does not become presented in a generalized manner as specificity remains critical. Unique case orientation will also be included within the analysis since the interventions under investigation are applied different among different participants. VII. Conclusion This research explores various interventions which are utilized in enhancing the provision of care to patients suffering from congestive heart failure disease. Many patients have to be admitted and despite medical interventions being administered readmission has remained prevalently common. A variety of the interventions that have been proposed for the congestive heart failure patients as they move back to their homes seem to be promising. Despite the general agreement that the post discharge care may be helpful, there is uncertainty on the other benefits of the intervention other than the health care utilization rates. Much research conducted in this topic have focused on different parameters and it creates difficulty in the determination of the relevance and appropriateness of the articles Moreover, there is little literature that explores the unintended outcomes and consequence of these interventions. This has therefore made it difficult conclude that the post discharge care among patients is beneficial in reducing the cases of readmission. Future studies in this field can focus on more specific elements of the post-acute interventions, through exploring a single intervention like planned clinic visits. This would be able to present the benefits of the visits with regard to the perceptions of individuals who have undergone and have been diagnosed with the condition. References Calvillo–King, L., Arnold, D., Eubank, K. J., Lo, M., Yunyongying, P., Stieglitz, H., & Halm, E. A. (2013). Impact of social factors on risk of readmission or mortality in pneumonia and heart failure: systematic review. Journal of General Internal Medicine, 28(2), 269–282. Creswell, J. W. (2013). Qualitative Inquiry and Research Design: Choosing Among Five Approaches (3rd ed.). London: Sage Publications. Denzin, N. K., & Lincoln, Y. S. (2011). The SAGE Handbook of Qualitative Research (4th ed.). London: Sage Publications. Hansen, L. O., Young, R. S., Hinami, K., Leung, A., & Williams, M. V. (2011). Interventions to reduce 30-day rehospitalization: a systematic review. Annals of Internal Medicine, 155(8), 520–528. Healy, P., & Devane, D. (2011). Methodological considerations in cohort study designs. 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