title: A Retrospective Comparison of Home Telehealth and Nursing Care With or Without Rehabilitation Therapy on Rehospitalization Rates of Individuals With Heart Failure.
abstract: OBJECTIVE
  Congestive heart failure (CHF) is the most common reason for rehospitalization among the aging population, accounting for one-fifth of all hospital admissions. To date, there is no research comparing the rehospitalization rates between patients with CHF (PWCHF) who receive telehealth and home health nursing care versus a multidisciplinary team consisting of telehealth, home nursing, physical therapy (PT), and/or occupational therapy (OT).
  
  
  METHODS
  A retrospective analysis was performed with 132 Medicare Part A home health patients discharged from an inpatient setting with a primary or secondary diagnosis of CHF receiving daily telehealth over the course of 1 year. Allscripts Home Care and Lifestream software was used to query data from patient records. Rehospitalization rates were analyzed using Cochran-Mantel-Haenszel tests. Patients were divided into 3 groups: (1) nursing only; (2) nursing and PT or OT; or (3) nursing, PT, and OT.
  
  
  RESULTS
  A total of 41 of the 132 patients (31.06%) were rehospitalized during their home health 60-day episode of care. This percentage includes all-cause rehospitalizations. Cochran-Mantel-Haenszel tests indicated there were no differences in rehospitalization rates between the 3 groups after controlling for the confounding variables: (1) multiple hospitalizations (P = .15); (2) history of falls (P = .16); or (3) depression (P = .18).
  
  
  CONCLUSIONS
  There was no statistically significant difference between the 3 groups for all-cause rehospitalization rates. Further prospective research is required to determine best practices and multidisciplinary protocols to further reduce rehospitalization rates in this population.
authors.affiliation: VNA Home Health Hospice, Portland, Maine (Ms Martin and Dr Anderson); Department of Physical Therapy, University of Arkansas for Medical Sciences, Fayetteville (Dr Vincenzo); and University of Wah, Wah Cantt, Pakistan (Dr Yousuf Zai).
authors.forename: Stacy
authors.initials: S
authors.lastname: Martin
authors.forename: Bill
authors.initials: B
authors.lastname: Anderson
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Vincenzo
authors.forename: Sajid Yousuf
authors.initials: SY
authors.lastname: Zai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000072038:Cardiac Rehabilitation / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000451:nursing / Q000534:rehabilitation / Q000628:therapy*; D006801:Humans; D008297:Male; D009732:Nursing Care / Q000379:methods*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D017216:Telemedicine / Q000379:methods*; D016896:Treatment Outcome