Effects of hospital-to-home transitional care on health outcomes of elderly patients in Islamic Republic of Iran

Abstract

Background: Hospitalization has a negative effect on the functional and clinical outcomes of elderly patients. Aims: To evaluate the effect of a care transition intervention on functional and clinical outcomes and quality-of-life of elderly patients in the Islamic Republic of Iran after hospital discharge during a 3-month follow-up. Methods: We conducted a randomized controlled trial of 304 elderly hospitalized patients in Tehran from December 2018 to January 2020. The intervention group (n = 152) received care transition intervention and the control group (n = 152) received routine hospital discharge. All patients were assessed during hospital stay and at 30, 60 and 90 days after hospital discharge. Participants were evaluated using the Minimum Data Set–Home Care form, which assesses daily living activity, instrumental daily living activity, cognitive performance, cognition, pain, and depression. Rehospitalization and qualityof-life were evaluated, and differences between the groups and trends in quality-of-life were assessed. Results: Only instrumental daily living activity in the functional outcomes and quality-of-life were greater in the intervention group than the controls. The intervention (odds ratio (OR): 0.11; 95% confidence intervals (CI): 0.01–0.97), age (OR: 1.16; 95% CI: 1.01–1.33), and cognition (OR: 1.24; 95% CI: 1.02–1.51) predicted instrumental daily living activity. Age (coefficient: –0.009, P = 0.001), depression (coefficient: –0.157; P < 0.001), cognition (coefficient: –0.023, P < 0.001) and pain (coefficient: –0.106, P = 0.007) predicted quality-of-life. Conclusion: Care transition interventions can help maintain the independence of older adults after hospital discharge and improve their quality-of-life.