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Grand-Aides Markedly Reduce 6-Month and 30-Day Readmissions and Emergency Department Visits for Patients with Heart Failure: A Randomized Clinical Trial

Received: 19 April 2022    Accepted: 5 May 2022    Published: 12 May 2022
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Abstract

While numerous approaches have been used to reducing hospital readmissions, few have been subjected to a randomized clinical trial (RCT). This RCT studied the effectiveness of a “Grand-Aides” home visitation program in the reduction of readmissions and emergency department (ED) visits for patients with heart failure. High-risk patients (N=97) were randomized to receive care either with Grand-Aides or an established program to reduce readmissions at one hospital over two years; 85% were covered by Medicare + Medicaid (“Dual Eligibles”). Grand-Aides patients had home visits, while the control patients received telephone follow-up from community health workers. Data on all-cause readmissions and all-cause ED visits were collected at 30 and 180 days. At 6 months: patients with Grand-Aides had a 60% reduction in all-cause 6-month readmissions (65% controls and 26% Grand-Aides), p<0.001, and a 67% reduction in all-cause emergency department visits (33% controls, 11% Grand-Aides), p<0.01. For readmissions in the first 30 days, patients with Grand-Aides had a 48% reduction in readmissions (42% controls, 21.7% Grand-Aides, p=0.03) and a 79% reduction in 30-day all-cause emergency. In the first randomized clinical trial on readmissions and ED, the Grand-Aides program showed significant reductions in patients with heart failure, as compared to the best available program at the time in our health system, suggesting the impact that regular tailored home visits can have on reducing hospital resource utilization and costs. Took out sections.

Published in Science Journal of Clinical Medicine (Volume 11, Issue 2)
DOI 10.11648/j.sjcm.20221102.11
Page(s) 40-44
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Readmissions, Emergency Department, Heart Failure, Grand-Aides, Cost Reduction, Care Management, Randomized CLINICAL Trial

References
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Cite This Article
  • APA Style

    Kathleen Reeves, Nicolle Strand, Byron Udegbe, Bryson Hoover-Hankerson, Steuart Wright, et al. (2022). Grand-Aides Markedly Reduce 6-Month and 30-Day Readmissions and Emergency Department Visits for Patients with Heart Failure: A Randomized Clinical Trial. Science Journal of Clinical Medicine, 11(2), 40-44. https://doi.org/10.11648/j.sjcm.20221102.11

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    ACS Style

    Kathleen Reeves; Nicolle Strand; Byron Udegbe; Bryson Hoover-Hankerson; Steuart Wright, et al. Grand-Aides Markedly Reduce 6-Month and 30-Day Readmissions and Emergency Department Visits for Patients with Heart Failure: A Randomized Clinical Trial. Sci. J. Clin. Med. 2022, 11(2), 40-44. doi: 10.11648/j.sjcm.20221102.11

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    AMA Style

    Kathleen Reeves, Nicolle Strand, Byron Udegbe, Bryson Hoover-Hankerson, Steuart Wright, et al. Grand-Aides Markedly Reduce 6-Month and 30-Day Readmissions and Emergency Department Visits for Patients with Heart Failure: A Randomized Clinical Trial. Sci J Clin Med. 2022;11(2):40-44. doi: 10.11648/j.sjcm.20221102.11

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  • @article{10.11648/j.sjcm.20221102.11,
      author = {Kathleen Reeves and Nicolle Strand and Byron Udegbe and Bryson Hoover-Hankerson and Steuart Wright and Victor Jegede and Susan Freeman and Jeffrey Slocum and Arthur Garson},
      title = {Grand-Aides Markedly Reduce 6-Month and 30-Day Readmissions and Emergency Department Visits for Patients with Heart Failure: A Randomized Clinical Trial},
      journal = {Science Journal of Clinical Medicine},
      volume = {11},
      number = {2},
      pages = {40-44},
      doi = {10.11648/j.sjcm.20221102.11},
      url = {https://doi.org/10.11648/j.sjcm.20221102.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjcm.20221102.11},
      abstract = {While numerous approaches have been used to reducing hospital readmissions, few have been subjected to a randomized clinical trial (RCT). This RCT studied the effectiveness of a “Grand-Aides” home visitation program in the reduction of readmissions and emergency department (ED) visits for patients with heart failure. High-risk patients (N=97) were randomized to receive care either with Grand-Aides or an established program to reduce readmissions at one hospital over two years; 85% were covered by Medicare + Medicaid (“Dual Eligibles”). Grand-Aides patients had home visits, while the control patients received telephone follow-up from community health workers. Data on all-cause readmissions and all-cause ED visits were collected at 30 and 180 days. At 6 months: patients with Grand-Aides had a 60% reduction in all-cause 6-month readmissions (65% controls and 26% Grand-Aides), p<0.001, and a 67% reduction in all-cause emergency department visits (33% controls, 11% Grand-Aides), p<0.01. For readmissions in the first 30 days, patients with Grand-Aides had a 48% reduction in readmissions (42% controls, 21.7% Grand-Aides, p=0.03) and a 79% reduction in 30-day all-cause emergency. In the first randomized clinical trial on readmissions and ED, the Grand-Aides program showed significant reductions in patients with heart failure, as compared to the best available program at the time in our health system, suggesting the impact that regular tailored home visits can have on reducing hospital resource utilization and costs. Took out sections.},
     year = {2022}
    }
    

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    AB  - While numerous approaches have been used to reducing hospital readmissions, few have been subjected to a randomized clinical trial (RCT). This RCT studied the effectiveness of a “Grand-Aides” home visitation program in the reduction of readmissions and emergency department (ED) visits for patients with heart failure. High-risk patients (N=97) were randomized to receive care either with Grand-Aides or an established program to reduce readmissions at one hospital over two years; 85% were covered by Medicare + Medicaid (“Dual Eligibles”). Grand-Aides patients had home visits, while the control patients received telephone follow-up from community health workers. Data on all-cause readmissions and all-cause ED visits were collected at 30 and 180 days. At 6 months: patients with Grand-Aides had a 60% reduction in all-cause 6-month readmissions (65% controls and 26% Grand-Aides), p<0.001, and a 67% reduction in all-cause emergency department visits (33% controls, 11% Grand-Aides), p<0.01. For readmissions in the first 30 days, patients with Grand-Aides had a 48% reduction in readmissions (42% controls, 21.7% Grand-Aides, p=0.03) and a 79% reduction in 30-day all-cause emergency. In the first randomized clinical trial on readmissions and ED, the Grand-Aides program showed significant reductions in patients with heart failure, as compared to the best available program at the time in our health system, suggesting the impact that regular tailored home visits can have on reducing hospital resource utilization and costs. Took out sections.
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Author Information
  • Lenfest Center for Community Workforce Partnerships, Temple University Health System, Philadelphia, the United States

  • Center for Urban Bioethics, Lewis Katz School of Medicine, Philadelphia, the United States

  • Center for Urban Bioethics, Lewis Katz School of Medicine, Philadelphia, the United States

  • Center for Urban Bioethics, Lewis Katz School of Medicine, Philadelphia, the United States

  • Center for Urban Bioethics, Lewis Katz School of Medicine, Philadelphia, the United States

  • Center for Urban Bioethics, Lewis Katz School of Medicine, Philadelphia, the United States

  • ROffice of the Provost, Rush University, Chicago, the United States

  • Lenfest Center for Community Workforce Partnerships, Temple University Health System, Philadelphia, the United States

  • Department of Health Systems and Population Health Sciences, College of Medicine, University of Houston, Houston, the United States

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