Abstract

Rehospitalization rates of 20% within 30 days of hospital discharge and 27% within 60 days are one of the highest strains on the federal Medicare budget. The Center for Medicare and Medicaid Services (CMS) has responded by imposing financial disincentives in reimbursement regulations directed to those providers deemed responsible for preventable rehospitalizations. Identifying cost-effective interventions that are appropriate for individuals with chronic illnesses that may be provided within the current home health care system of reimbursement is critical. The purpose of this quasi-scientific intervention study was to test the efficacy of a cost-effective, nurse-led intervention to decrease rehospitalizations of community dwelling older adult Medicare beneficiaries receiving certified home health services following an acute care hospital admission. The intervention was based on Eric Coleman's Care Transition Intervention SM utilizing a personal health record, patient goal setting, and knowledge of "red flags" or changes in condition. Coaching by the home care nurses was added to Coleman's intervention to facilitate support of patient self-management.

Description

This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 3549185; ProQuest document ID: 1283382853. The author still retains copyright.

Author Details

Merrily W. Evdokimoff, PhD, RN

Sigma Membership

Alpha Chi

Lead Author Affiliation

University of Massachusetts, Boston, Massachusetts, USA

Type

Dissertation

Format Type

Text-based Document

Study Design/Type

Quasi-Experimental Study, Other

Research Approach

Quantitative Research

Keywords:

Home Health Care, Older Adults, Rehospitalization

Advisor

Rosanna DeMarco

Degree

PhD

Degree Grantor

Boston College

Degree Year

2012

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Proxy-submission

Date of Issue

2019-03-01

Full Text of Presentation

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