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An effectiveness and cost-benefit analysis of a hospital-based discharge transition program for elderly medicare recipients

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dc.contributor.author Saleh S.S.
dc.contributor.author Freire C.
dc.contributor.author Morris-Dickinson G.
dc.contributor.author Shannon T.
dc.contributor.editor
dc.date 2012
dc.date.accessioned 2017-10-18T13:35:49Z
dc.date.available 2017-10-18T13:35:49Z
dc.date.issued 2012
dc.identifier 10.1111/j.1532-5415.2012.03992.x
dc.identifier.isbn
dc.identifier.issn 00028614
dc.identifier.uri http://hdl.handle.net/10938/20600
dc.description.abstract OBJECTIVE: To investigate the business case of postdischarge care transition (PDCT) among Medicare beneficiaries by conducting a cost-benefit analysis. DESIGN: Randomized controlled trial. SETTING: A general hospital in upstate New York State. PARTICIPANTS: Elderly Medicare beneficiaries being treated from October 2008 through December 2009 were randomly selected to receive services as part of a comprehensive PDCT program (intervention-173 patients) or regular discharge process (control-160 patients) and followed for 12 months. INTERVENTION: The intervention comprised five activities: development of a patient-centered health record, a structured discharge preparation checklist of critical activities, delivery of patient self-activation and management sessions, follow-up appointments, and coordination of data flow. MEASUREMENTS: Cost-benefit ratio of the PDCT program; self-management skills and abilities. RESULTS: The 1-year readmission analysis revealed that control participants were more likely to be readmitted than intervention participants (58.2percent vs 48.2percent; P = .08); with most of that difference observed in the 91 to 365 days after discharge. Findings from the cost-benefit analysis revealed a cost-benefit ratio of 1.09, which indicates that, for every $1 spent on the program, a saving of $1.09 was realized. In addition, participating in a care transition program significantly enhanced self-management skills and abilities. CONCLUSION: Postdischarge care transition programs have a dual benefit of enhancing elderly adults' self-management skills and abilities and producing cost savings. This study builds a case for the inclusion of PDCT programs as a reimbursable service in benefit packages. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.
dc.format.extent
dc.format.extent Pages: (1051-1056)
dc.language English
dc.publisher HOBOKEN
dc.relation.ispartof Publication Name: Journal of the American Geriatrics Society; Publication Year: 2012; Volume: 60; no. 6; Pages: (1051-1056);
dc.relation.ispartofseries
dc.relation.uri
dc.source Scopus
dc.subject.other
dc.title An effectiveness and cost-benefit analysis of a hospital-based discharge transition program for elderly medicare recipients
dc.type Article
dc.contributor.affiliation Saleh, S.S., Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Van Dyck, P.O. Box 11-0236, Raid El Sohl, Beirut 1107 2020, Beirut, Lebanon
dc.contributor.affiliation Freire, C., Glens Falls Hospital, Glens Falls, NY, United States
dc.contributor.affiliation Morris-Dickinson, G., Hudson Headwaters Health Network, Glens Falls, NY, United States
dc.contributor.affiliation Shannon, T., Hudson Headwaters Health Network, Glens Falls, NY, United States
dc.contributor.authorAddress Saleh, S.S.; Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Van Dyck, P.O. Box 11-0236, Raid El Sohl, Beirut 1107 2020, Beirut, Lebanon; email: ss117@aub.edu.lb
dc.contributor.authorCorporate University: American University of Beirut; Faculty: Faculty of Health Sciences; Department: Health Management and Policy;
dc.contributor.authorDepartment Health Management and Policy
dc.contributor.authorDivision
dc.contributor.authorEmail ss117@aub.edu.lb
dc.contributor.authorFaculty Faculty of Health Sciences
dc.contributor.authorInitials Saleh, SS
dc.contributor.authorInitials Freire, C
dc.contributor.authorInitials Morris-Dickinson, G
dc.contributor.authorInitials Shannon, T
dc.contributor.authorOrcidID
dc.contributor.authorReprintAddress Saleh, SS (reprint author), Amer Univ Beirut, Dept Hlth Management and Policy, Fac Hlth Sci, Room IIIC,POB 11-0236, Beirut 11072020, Lebanon.
dc.contributor.authorResearcherID
dc.contributor.authorUniversity American University of Beirut
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dc.description.citedCount 4
dc.description.citedTotWOSCount 3
dc.description.citedWOSCount 3
dc.format.extentCount 6
dc.identifier.articleNo
dc.identifier.coden JAGSA
dc.identifier.pubmedID 22690981
dc.identifier.scopusID 84862239478
dc.identifier.url
dc.publisher.address 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
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dc.relation.ispartofConferenceCode
dc.relation.ispartofConferenceDate
dc.relation.ispartofConferenceHosting
dc.relation.ispartofConferenceLoc
dc.relation.ispartofConferenceSponsor
dc.relation.ispartofConferenceTitle
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dc.relation.ispartOfISOAbbr J. Am. Geriatr. Soc.
dc.relation.ispartOfIssue 6
dc.relation.ispartOfPart
dc.relation.ispartofPubTitle Journal of the American Geriatrics Society
dc.relation.ispartofPubTitleAbbr J. Am. Geriatr. Soc.
dc.relation.ispartOfSpecialIssue
dc.relation.ispartOfSuppl
dc.relation.ispartOfVolume 60
dc.source.ID WOS:000305131900007
dc.type.publication Journal
dc.subject.otherAuthKeyword Cost-benefit
dc.subject.otherAuthKeyword Elderly
dc.subject.otherAuthKeyword Medicare
dc.subject.otherAuthKeyword Postdischarge care transition
dc.subject.otherChemCAS
dc.subject.otherIndex aged
dc.subject.otherIndex article
dc.subject.otherIndex controlled study
dc.subject.otherIndex cost benefit analysis
dc.subject.otherIndex elderly care
dc.subject.otherIndex female
dc.subject.otherIndex hospital discharge
dc.subject.otherIndex hospital readmission
dc.subject.otherIndex human
dc.subject.otherIndex major clinical study
dc.subject.otherIndex male
dc.subject.otherIndex medical record
dc.subject.otherIndex medicare
dc.subject.otherIndex patient care
dc.subject.otherIndex randomized controlled trial
dc.subject.otherIndex Aged
dc.subject.otherIndex Aged, 80 and over
dc.subject.otherIndex Chi-Square Distribution
dc.subject.otherIndex Continuity of Patient Care
dc.subject.otherIndex Cost-Benefit Analysis
dc.subject.otherIndex Costs and Cost Analysis
dc.subject.otherIndex Female
dc.subject.otherIndex Humans
dc.subject.otherIndex Intervention Studies
dc.subject.otherIndex Male
dc.subject.otherIndex Medicare
dc.subject.otherIndex New York
dc.subject.otherIndex Patient Discharge
dc.subject.otherIndex Patient Readmission
dc.subject.otherIndex United States
dc.subject.otherKeywordPlus RANDOMIZED CLINICAL-TRIAL
dc.subject.otherKeywordPlus CARE TRANSITIONS
dc.subject.otherKeywordPlus OLDER PATIENTS
dc.subject.otherKeywordPlus HEART-FAILURE
dc.subject.otherKeywordPlus REHOSPITALIZATION
dc.subject.otherKeywordPlus OPPORTUNITIES
dc.subject.otherKeywordPlus INFORMATION
dc.subject.otherKeywordPlus CHALLENGES
dc.subject.otherKeywordPlus QUALITY
dc.subject.otherWOS Geriatrics and Gerontology
dc.subject.otherWOS Gerontology


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