Sample Research Paper on Post Discharge Care Transition

Presentation of Evidence

Parry et al.(2003)conducted a cost-benefit analysis to determine the business case for
beneficiaries of Medicare through post discharge care transition(PDCT) .The measurement for
in this research included the PDCT cost benefit ratio and the abilities and skills of self-
management that recipients posed .This study was based on a controlled randomized trial. The
study was carried out on elderly recipients receiving treatment at a general hospital located in a
rural area called upstate in New York. The research was carried out from October 2008 to
December 2009. The recipients selected were provided with services as part of the PDCT
intervention while the others were controlled through regular discharge from the hospital. The
participants were selected randomly before discharge from the hospital. Inclusion and exclusion
criteria were used during the study after the census of the patients’ daily medical care was
obtained. Based on the medical number and record of individuals, they were randomly assigned
to intervention and control groups. Three hundred and thirty three recipients were chosen for this
study: 160 in the intervention group and 173 in the control group (Parry et al., 2003).
Participants in this program were approached while they were hospitalized, and the
program was explained to them before they signed the consent forms. The program consisted of
three home visits by nurses who were tasked with the role of delivering the program. The
intervention features included developing the records of patients, structuring a discharge
checklist for patients, providing sessions to improve recipient management and self-activation,
check-up sessions and coordinating information. Data was analyzed using various techniques
during the intervention. Island Peer Review Organization discharge criteria were used to assess
the discharge risk level. Cole man’s Care Transitions Measure survey was used to determine

recipient’s skills and abilities of self –management. Other methods of analyzing data include the
use of SAS version 9.1.
The medical conditions assessed for the participants in the two groups using IPRO
method showed that participants in the intervention group were a high risk lot at 46.8%
compared to the control group which had 35.7% (P=.03). The Index admission table reveals that
most of the recipients had Medicare as their main insurance and the emergency department was
their admittance way to the hospital. Other medical players for participants included Medicaid,
Blue Cross and commercial insurance firms (Greenwald, Denham & Jack, 2007). The indexing
table also showed that controlled recipients were likely to be more eligible to home discharge
compared with those referred to care givers especially the intervention recipients (Greenwald,
Denham & Jack, 2007).
The analysis carried out in readmission showed that controlled group participants were
more likely to be readmitted than those in the intervention 58.2% versus 48.2% ( P=.08).The
analysis also showed there was a higher rate of readmission for participants in the intervention
group for the time frame of 30 days. This was reversed when the readmission rate was examined
in the 31 to 90 day duration. The cost analysis was done to compare the saving in the
intervention group with the overall program revealed that a participant in the intervention and
control groups saved $1,034 and $946 for an intervention participant for the cost of the program
(Coleman & Berenson, 2004). There was a cost benefit ratio of 1.09 meaning that there was a
saving of $1.09 realized for every $1 used during the program.
Peikes et al. (2009) use of Cole man’s Care Transitions Measure survey to determine the
effect of participant self -management skills and abilities revealed many things. The study

suggests that there was enhanced understanding in many areas of the participants. These included
understanding health management for every individual (P= .003).The participants were able to
understand the signs and warning symptoms to watch out after knowing their health status (P=
.004), there was increased confidence on how to manage health issues by the participants (P=
.03), having the independence to carry tasks that reflected on their health (P= .03). The study also
shows that participants were able to understand the written draft explaining the program and how
it was going to be implemented (P= .01). Further studies revealed that individuals in the
intervention group were able to understand the reason of taking medication compared to the
control participants (P= .008). This figure was also reflected when the study compared the
understanding of the side effects brought by the medications for the participants in the control
and intervention groups (Greenwald, Denham & Jack, 2007).
The study results from techniques implemented revealed that post discharge care
transition (PDCT) program had the ability to improve health care and reduce the costs. This is
mostly important for societies that have complex health situations. The study was set in a
population that comprised the Elderly in the society who need proper care. The author also
reflected on the effects of this program and how it would influence the skills and abilities of the
participants to manage their health issues. The findings in this program demonstrated that it was
cost beneficial because for every dollar spent, a $1.09 was realized in savings attributed to the
reduced rates of readmission. It also improved skills and abilities of self-management among the
participants (Coleman & Berenson, 2004).



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