Frances Wong is a professor at the Hong Kong Polytechnic University.
Our recent research has revealed very interesting findings about the power of a telephone call as compared to home visits for post-discharged patients. Patients are discharged from the hospital as soon as the immediate problems are resolved. Some care issues only emerge when the patients return home. The issues usually involve patients’ confidence and ability for self-care, symptom management, adherence to medication regimen and so on. If these concerns are not addressed properly, the patients will present themselves to the hospitals again. Like a revolving door syndrome, patients returning to the community come back to the hospital within a short time. The mean readmission rate within 28 days after discharge is 15% and the rate can escalate to 35% for the chronically ill patients.
In combating the issue of readmission, there are transitional care programmes in supporting the post-discharged patients. The frequently used strategies for these programmes are home visits and telephone calls. Home visits require more arrangement and consume more resources than telephone calls. However, one is not sure about the differential benefits between home visits and telephone calls. The following table displays a comparison between home visits and telephone calls for transitional care. In our experimental study, we found that the call groups were cheaper, brought about better quality of life value and had higher chance of cost-effectiveness. The home group exceeded the call group in having higher net savings due to the better rate in controlling the 28-day hospital readmission rate (home 10.7% vs call 11.8% vs control 17.6%). In conclusion, we got a better deal with telephone calls in following up patients after discharge which is less costly and enhance patients’ well-being. Telephone involves simple technology that is easily accessible to those who are in need. In making use of the simple measure in life, we can do great things for people and save money!
A comparison of the performance of home visits and telephone calls
|Intervention Costs||$997||$451√ Cheaper|
|Net incremental costs||-1398/-2374 (28/84 days post discharge)√ Higher net savings||-296/ -1966 (28/84 days post discharge)|
|Quality of Life (QOL)||-0.0002/+0.0008(28/84 days post discharge)
|+0.0022/+0.0104(28/84 days post discharge)
√ Better QOL
|Chance of being cost-effective||53%/22%(28/84 days post discharge)
|35%/74%(84-days) (28/84 days post discharge)
√ Better chance of cost-effectiveness
The paper can be read in full on the Age and Ageing journal website, here.