Skip to main content
Erschienen in: Journal of General Internal Medicine 10/2019

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

Einloggen, um Zugang zu erhalten

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.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
3.
Zurück zum Zitat Fingar KR, Barrett ML, Elixhauser A, Stocks C, Steiner CA. Trends in Potentially Preventable Inpatient Hospital Admissions and Emergency Department Visits: Statistical Brief #195. Healthc Cost Util Proj Stat Briefs. 2015;(November):1–20. http://www.ncbi.nlm.nih.gov/pubmed/26741014. Accessed 11 Nov 2018. Fingar KR, Barrett ML, Elixhauser A, Stocks C, Steiner CA. Trends in Potentially Preventable Inpatient Hospital Admissions and Emergency Department Visits: Statistical Brief #195. Healthc Cost Util Proj Stat Briefs. 2015;(November):1–20. http://​www.​ncbi.​nlm.​nih.​gov/​pubmed/​26741014. Accessed 11 Nov 2018.
14.
24.
Zurück zum Zitat Andersen RM, Davidson PL, Baumeister SE. Improving Access to Care. In: Changing the US Health Care System: Key Issues in Health Services Policy and Management. Jossey-Bass San Francisco; 2013:33–69. Andersen RM, Davidson PL, Baumeister SE. Improving Access to Care. In: Changing the US Health Care System: Key Issues in Health Services Policy and Management. Jossey-Bass San Francisco; 2013:33–69.
34.
Zurück zum Zitat Leiva-Fernández F, Leiva-Fernández J, Zubeldia-Santoyo F, García-Ruiz A, Prados-Torres D, Barnestein-Fonseca P. Efficacy of two educational interventions about inhalation techniques in patients with chronic obstructive pulmonary disease (COPD). TECEPOC: study protocol for a partially randomized controlled trial (preference trial). Trials. 2012;13(1):64. https://doi.org/10.1186/1745-6215-13-64 CrossRefPubMedPubMedCentral Leiva-Fernández F, Leiva-Fernández J, Zubeldia-Santoyo F, García-Ruiz A, Prados-Torres D, Barnestein-Fonseca P. Efficacy of two educational interventions about inhalation techniques in patients with chronic obstructive pulmonary disease (COPD). TECEPOC: study protocol for a partially randomized controlled trial (preference trial). Trials. 2012;13(1):64. https://​doi.​org/​10.​1186/​1745-6215-13-64 CrossRefPubMedPubMedCentral
Metadaten
Titel
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
Publikationsdatum
05.08.2019
Verlag
Springer International Publishing
Erschienen in
Journal of General Internal Medicine / Ausgabe 10/2019
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-019-05135-y

Weitere Artikel der Ausgabe 10/2019

Journal of General Internal Medicine 10/2019 Zur Ausgabe

Letter to the Editor

Letter to the Editor

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.