RANDOMIZED CLINICAL TRIAL

Randomized Clinical Trial to Reduce Re-hospitalization

Randomized Clinical Trial to Reduce Re-hospitalization

Introduction

In order to check the validity and reliability of a methodology it is necessary to implement the same methodology in another research. This ensures the validity and reliability of a methodology if the methodology brings similar outcomes if implemented in another scenario. In addition, this also ensures that whether the results obtained through the methodology can be generalized or not. Therefore, this study used RCT in another research; however, the purpose of the research was similar, that is to decrease the re-hospitalization of patients for quality improvement. Hospital re-admission is a major public health problem. This has raised a major issue in the field of health sector; because the increase in hospital re-admission is diminishing the quality standards of the health sector.

The general aging of the population and the prolonged survival of patients and hypertension have increased in prevalence, becoming the most frequent cause of hospitalization among patients over age 65 (Greenwald, Denham, Jack, 2007). A research suggests that the hospital re-admission has increased in patients with and care for these patients is 1-2% of the total budget for health care in industrialized countries (Greenwald, Denham, Jack, 2007). Most of this expense is due to episodes of re-hospitalization, and that between 29 and 47% of patients with IC is again entered at 3-6 months after a first admission. In United States, half of patients hospitalized with HF have been admitted earlier for the same reason at least once (Wachter, 2004).

The causes of readmission are varied; the most important are the lack of compliance with medical regimen prescribed, the prescription of inadequate treatment, and lack of social support or inadequate follow-up after hospital discharge (Moore, Wisnivesky, Williams, McGinn, 2003). Many of the crises that require re-entry could be avoided. In particular, numerous studies show that a proper multidisciplinary program, essentially educational in nature, can significantly reduce the number, duration and cost of readmissions and even the mortality rate among patients with IC (Kripalani et al. 2007). In a recent meta-analysis were collected 27 randomized studies with no randomized trial to assess the effectiveness of various programs of comprehensive care and re-admission probability in elderly patients (Mezey, Fulmer, Abraham, 2006).

Briefly, according to data from 10 randomized studies, the interventions reduced the combined outcome of readmission or death by 18% (Walraven et al. 2002). These interventions were designed and adapted to local possibilities and resources, with a wide variety of content and professions. The question that arises therefore is: what is the best use of local resources? The provision of multidisciplinary care in the patient's home is not available to many centers, but limit efforts to reduce readmissions to the performances at clinics or purely educational measures may be ineffective (Walraven et al. 2002). This study presents the results of an evaluation in terms of reducing the rate of readmissions and deaths each year, of a short-term education basically carried out in patients' homes through a home care unit existing, available in ...