Erschienen in:
05.08.2019 | Original Research
Teach-Back Experience and Hospitalization Risk Among Patients with Ambulatory Care Sensitive Conditions: a Matched Cohort Study
verfasst von:
Young-Rock Hong, MPH, Michelle Cardel, PhD, MS, RD, Ryan Suk, MS, Ivana A. Vaughn, PhD, MPH, Ashish A. Deshmukh, PhD, MPH, Carla L. Fisher, PhD, Gregory Pavela, PhD, Kalyani Sonawane, PhD
Erschienen in:
Journal of General Internal Medicine
|
Ausgabe 10/2019
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Abstract
Background
The teach-back method, also known as the “show-me” method, has been endorsed by many medical and health care societies. However, limited investigation has been conducted regarding its association with patient outcomes.
Objectives
To examine the association between patient teach-back experience and the risk of hospitalizations and length of hospital stay among patients with ambulatory care sensitive conditions (ACSCs).
Design
A matched cohort study.
Setting
Data from the 2011–2015 Longitudinal Medical Expenditure Panel Survey (panels 16–19).
Participants
Three thousand nine hundred ninety-four US adults aged ≥ 18 years with any of 5 ACSCs (hypertension, type 2 diabetes, heart disease, asthma, and chronic obstructive pulmonary disease [COPD]).
Measurements
Hospital admissions (all-cause or ACSC-related) and the length of stay of the first admission were examined by teach-back during interaction with a health provider.
Results
Patients with teach-back experience were less likely to experience hospitalization for an ACSC-related condition (relative risk, 0.85; 95% CI, 0.71 to 0.99) and had a lower risk for a condition-related readmission (hazard ratio, 0.77; 95% CI, 0.60 to 0.99), compared with those without teach-back experience. The median length of hospital stay did not differ between patients with teach-back experience and those without teach-back experience (median 3 days [IQR 1 to 8 days] and median 3 days [IQR 0 to 8 days], respectively; P = 0.84). Subgroup analysis showed that the association of reported teach-back experience on the outcomes was relatively stable among those with hypertension, diabetes, and heart disease, but was not among those with asthma or COPD.
Limitation
Teach-back exposure relied on patient self-reported information.
Conclusions
Our findings suggest that patient teach-back method is associated with reduced risk of hospitalization for those with ACSCs, especially among patients with cardiovascular diseases and type 2 diabetes. Encouraging providers to utilize the teach-back method at every visit has the potential to further reduce hospitalizations for individuals with ACSCs.