Including Informal Caregivers of Elderly in Discharge Process Reduces Readmission Risk
Studies that integrated caregivers into discharge planning saw a 25% reduction in risk of readmission within 90 days.
Involving informal caregivers in the discharge planning process of elderly patients reduces the risk of hospital readmissions finds a meta-analysis published in the Journal of the American Geriatric Society. The findings are consistent with current recommendations by the Caregiver Advise, Record and Enable (CARE) Act, which has been adopted by more than 30 states and the District of Columbia, and proposed Medicare regulations that require caregiver identification and training before patients leave a health facility.
To assess the impact of informal caregivers on hospital readmission, the researchers analyzed 10,715 scientific publications related to discharge planning for older patients. The analysis was narrowed down to 15 publications that included randomized control trials and provided other relevant information and data. The meta-analysis included 4361 patients with an average age of 70 years.
The study found that two-thirds of informal caregivers were female, 61% were a spouse or a partner, and 35% were adult children. Those studies that integrated caregivers into discharge planning saw a 25% reduction in risk of readmission within 90 days, and a 24% reduction in risk of readmission within 180 days.
Caregiver integration at discharge differed across studies. Some studies connected patients and caregivers with community resources. Others provided written care plans or used learning validation tools, where a caregiver was trained and demonstrated that training to an instructor.
"Due to medical advances, shorter hospital stays and the expansion of home care technology, caregivers are taking on considerable care responsibilities for patients," said lead investigator Juleen Rodakowski, OTD, MS, OTR/L, assistant professor in the Department of Occupational Therapy in Pitt's School of Health and Rehabilitation Sciences. "This includes increasingly complex treatment, such as wound care, managing medications, and operating specialized medical equipment. With proper training and support, caregivers are more likely to be able to fulfill these responsibilities and keep their loved ones from having to return to the hospital."
1. Rodakowski J, Rocco PB, Ortiz M, et al. Caregiver integration during discharge planning for older adults to reduce resource use: a metaanalysis [published online April 3, 2017]. J Am Geriatr Soc. doi:10.1111/jgs.14873