Nurse-led interventions designed to reduce readmissions in ethnically and linguistically diverse patient populations did not improve 30-day readmission rates, according to research from UC San Francisco.
The study, published in Annals of Internal Medicine, examined a group of 700 patients at an urban hospital aged 55 years or older who spoke English, Spanish or Chinese. One group of patients received usual care, while the other received in-hospital, one-on-one self-management education from a nurse along with a phone follow-up from a nurse practitioner. Researchers looked at emergency department visits as well as readmission rates using data from several hospitals.
After 30 days, readmission rates for both the usual care and intervention groups sat at about 15 percent, and emergency department visits in the intervention group may have been higher than for the usual care group, the researchers found.
"Our findings should give pause to hospitals adopting interventions shown to work in dissimilar populations and settings without evaluating their effect and should prompt consideration of alternate or additional approaches to reducing readmissions in populations with significant medical comorbidity and language diversity," said L. Elizabeth Goldman, MD, associate professor in the UCSF Division of General Internal Medicine at San Francisco General Hospital and Trauma Center and co-lead author of the study.
Margo Kushel, MD, professor of general internal medicine and senior author, added, "There has been a tremendous push nationally to adopt these hospital-based transitional care programs, particularly ones that require few additional resources. However, in this diverse elderly population, the intervention did not have an impact on key policy relevant outcomes."