title: [Efficacy of nursing planning after hospital discharge of patients over 65 to reduce their readmission].
abstract: OBJECTIVE
  To evaluate the efficacy of nursing care and monitoring of patients over 65 in primary care, to reduce the rate of readmission and to extend time till readmission.
  
  
  METHODS
  Non-randomised clinical trial with control.
  
  
  METHODS
  Base Area 8, Madrid, Spain. Primary and specialist care.
  
  
  METHODS
  Patients over 65 admitted from home with the pathologies under study. There were 97 patients in the study, 49 in the intervention group and 48 in the control group.
  
  
  METHODS
  In the intervention group, link nursing conducted visits every 48 hours and provided health education to carer and patient. Patients in the control group received conventional care. Patients in both groups were contacted by phone by primary care nurses 2, 6, 12, and 24 weeks after their hospital discharge.
  
  
  METHODS
  Readmission for the same reason was recorded. As a secondary variable, time till readmission was recorded.
  
  
  RESULTS
  Patients in the control group were admitted more often than those in the experimental group (OR, 3.3; 95% CI, 1.13-9.52; adjusted for the admission diagnosis). The result was consistent, on conducting an analysis of the time elapsed before readmission (HR, 2.29; 95% CI, 1.03-5.10; adjusted in the same way).
  
  
  CONCLUSIONS
  A planned intervention into discharges with full, individual evaluation reduces readmissions and increases the time till readmission in patients over 65.
authors.affiliation: Unidad de Bioestadística Clínica. Hospital Ramón y Cajal. Madrid. España. alejandra.cano@hrc.es
authors.forename: Alejandra
authors.initials: A
authors.lastname: Cano Arana
authors.forename: M Concepción
authors.initials: MC
authors.lastname: Martín Arribas
authors.forename: Magdalena
authors.initials: M
authors.lastname: Martínez Piédrola
authors.forename: Carmen
authors.initials: C
authors.lastname: García Tallés
authors.forename: Montserrat
authors.initials: M
authors.lastname: Hernández Pascual
authors.forename: Antonio
authors.initials: A
authors.lastname: Roldán Fernández
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D010347:Patient Care Planning; D010359:Patient Readmission / Q000706:statistics & numerical data*