PLoS ONE (Jan 2023)

Post-acute care for frail older people decreases 90-day emergency room visits, readmissions and mortality: An interventional study.

  • Min-Chang Lee,
  • Tai-Yin Wu,
  • Sheng-Jean Huang,
  • Ya-Mei Chen,
  • Sheng-Huang Hsiao,
  • Ching-Yao Tsai

DOI
https://doi.org/10.1371/journal.pone.0279654
Journal volume & issue
Vol. 18, no. 1
p. e0279654

Abstract

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BackgroundTo evaluate the effects of post-acute care (PAC) on frail older adults after acute hospitalization in Taiwan.MethodsThis was a multicenter interventional study. Frail patients aged ≥ 75 were recruited and divided into PAC or control group. The PAC group received comprehensive geriatric assessment (CGA) and multifactorial intervention including exercise, nutrition education, and medicinal adjustments for two to four weeks, while the control group received only CGA. Outcome measures included emergency room (ER) visits, readmissions, and mortality within 90 days after PAC.ResultsAmong 254 participants, 205 (87.6±6.0 years) were in the PAC and 49 (85.2±6.0 years) in the control group. PAC for more than two weeks significantly decreased 90-day ER visits (odds ratio [OR] 0.21, 95% confidence interval [CI] 0.10-0.43; p = 0.024), readmissions (OR 0.30, 95% CI 0.16-0.56; p ConclusionPAC program for more than two weeks could have beneficial effects on decreasing ER visits, readmissions, and mortality after an acute illness in frail older patients. Those who perceived severe problems in self-care and usual activities had a higher risk of subsequent adverse outcomes.Trial registrationClinicalTrials.gov NCT Identifier: NCT05452395.