Grand-Aides Markedly Reduce 6-Month and 30-Day Readmissions and Emergency Department Visits for Patients with Heart Failure: A Randomized Clinical Trial

Kathleen Reeves; Nicolle Strand; Byron Udegbe; Bryson Hoover-Hankerson; Steuart Wright; Victor Jegede; Susan Freeman; Jeffrey Slocum; Arthur Garson

doi:doi:10.11648/j.sjcm.20221102.11

Grand-Aides Markedly Reduce 6-Month and 30-Day Readmissions and Emergency Department Visits for Patients with Heart Failure: A Randomized Clinical Trial

Kathleen Reeves, Nicolle Strand, Byron Udegbe, Bryson Hoover-Hankerson, Steuart Wright, Victor Jegede, Susan Freeman, Jeffrey Slocum, Arthur Garson

Published in Science Journal of Clinical Medicine (Volume 11, Issue 2)

Received: 19 April 2022 Accepted: 5 May 2022 Published: 12 May 2022

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Abstract

While numerous approaches have been used to reducing hospital readmissions, few have been subjected to a randomized clinical trial (RCT). This RCT studied the effectiveness of a “Grand-Aides” home visitation program in the reduction of readmissions and emergency department (ED) visits for patients with heart failure. High-risk patients (N=97) were randomized to receive care either with Grand-Aides or an established program to reduce readmissions at one hospital over two years; 85% were covered by Medicare + Medicaid (“Dual Eligibles”). Grand-Aides patients had home visits, while the control patients received telephone follow-up from community health workers. Data on all-cause readmissions and all-cause ED visits were collected at 30 and 180 days. At 6 months: patients with Grand-Aides had a 60% reduction in all-cause 6-month readmissions (65% controls and 26% Grand-Aides), p<0.001, and a 67% reduction in all-cause emergency department visits (33% controls, 11% Grand-Aides), p<0.01. For readmissions in the first 30 days, patients with Grand-Aides had a 48% reduction in readmissions (42% controls, 21.7% Grand-Aides, p=0.03) and a 79% reduction in 30-day all-cause emergency. In the first randomized clinical trial on readmissions and ED, the Grand-Aides program showed significant reductions in patients with heart failure, as compared to the best available program at the time in our health system, suggesting the impact that regular tailored home visits can have on reducing hospital resource utilization and costs. Took out sections.

Published in	Science Journal of Clinical Medicine (Volume 11, Issue 2)
DOI	10.11648/j.sjcm.20221102.11
Page(s)	40-44
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Readmissions, Emergency Department, Heart Failure, Grand-Aides, Cost Reduction, Care Management, Randomized CLINICAL Trial

References

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APA Style

Kathleen Reeves, Nicolle Strand, Byron Udegbe, Bryson Hoover-Hankerson, Steuart Wright, et al. (2022). Grand-Aides Markedly Reduce 6-Month and 30-Day Readmissions and Emergency Department Visits for Patients with Heart Failure: A Randomized Clinical Trial. Science Journal of Clinical Medicine, 11(2), 40-44. https://doi.org/10.11648/j.sjcm.20221102.11

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ACS Style

Kathleen Reeves; Nicolle Strand; Byron Udegbe; Bryson Hoover-Hankerson; Steuart Wright, et al. Grand-Aides Markedly Reduce 6-Month and 30-Day Readmissions and Emergency Department Visits for Patients with Heart Failure: A Randomized Clinical Trial. Sci. J. Clin. Med. 2022, 11(2), 40-44. doi: 10.11648/j.sjcm.20221102.11

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AMA Style

Kathleen Reeves, Nicolle Strand, Byron Udegbe, Bryson Hoover-Hankerson, Steuart Wright, et al. Grand-Aides Markedly Reduce 6-Month and 30-Day Readmissions and Emergency Department Visits for Patients with Heart Failure: A Randomized Clinical Trial. Sci J Clin Med. 2022;11(2):40-44. doi: 10.11648/j.sjcm.20221102.11

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@article{10.11648/j.sjcm.20221102.11,
  author = {Kathleen Reeves and Nicolle Strand and Byron Udegbe and Bryson Hoover-Hankerson and Steuart Wright and Victor Jegede and Susan Freeman and Jeffrey Slocum and Arthur Garson},
  title = {Grand-Aides Markedly Reduce 6-Month and 30-Day Readmissions and Emergency Department Visits for Patients with Heart Failure: A Randomized Clinical Trial},
  journal = {Science Journal of Clinical Medicine},
  volume = {11},
  number = {2},
  pages = {40-44},
  doi = {10.11648/j.sjcm.20221102.11},
  url = {https://doi.org/10.11648/j.sjcm.20221102.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjcm.20221102.11},
  abstract = {While numerous approaches have been used to reducing hospital readmissions, few have been subjected to a randomized clinical trial (RCT). This RCT studied the effectiveness of a “Grand-Aides” home visitation program in the reduction of readmissions and emergency department (ED) visits for patients with heart failure. High-risk patients (N=97) were randomized to receive care either with Grand-Aides or an established program to reduce readmissions at one hospital over two years; 85% were covered by Medicare + Medicaid (“Dual Eligibles”). Grand-Aides patients had home visits, while the control patients received telephone follow-up from community health workers. Data on all-cause readmissions and all-cause ED visits were collected at 30 and 180 days. At 6 months: patients with Grand-Aides had a 60% reduction in all-cause 6-month readmissions (65% controls and 26% Grand-Aides), p<0.001, and a 67% reduction in all-cause emergency department visits (33% controls, 11% Grand-Aides), p<0.01. For readmissions in the first 30 days, patients with Grand-Aides had a 48% reduction in readmissions (42% controls, 21.7% Grand-Aides, p=0.03) and a 79% reduction in 30-day all-cause emergency. In the first randomized clinical trial on readmissions and ED, the Grand-Aides program showed significant reductions in patients with heart failure, as compared to the best available program at the time in our health system, suggesting the impact that regular tailored home visits can have on reducing hospital resource utilization and costs. Took out sections.},
 year = {2022}
}

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TY  - JOUR
T1  - Grand-Aides Markedly Reduce 6-Month and 30-Day Readmissions and Emergency Department Visits for Patients with Heart Failure: A Randomized Clinical Trial
AU  - Kathleen Reeves
AU  - Nicolle Strand
AU  - Byron Udegbe
AU  - Bryson Hoover-Hankerson
AU  - Steuart Wright
AU  - Victor Jegede
AU  - Susan Freeman
AU  - Jeffrey Slocum
AU  - Arthur Garson
Y1  - 2022/05/12
PY  - 2022
N1  - https://doi.org/10.11648/j.sjcm.20221102.11
DO  - 10.11648/j.sjcm.20221102.11
T2  - Science Journal of Clinical Medicine
JF  - Science Journal of Clinical Medicine
JO  - Science Journal of Clinical Medicine
SP  - 40
EP  - 44
PB  - Science Publishing Group
SN  - 2327-2732
UR  - https://doi.org/10.11648/j.sjcm.20221102.11
AB  - While numerous approaches have been used to reducing hospital readmissions, few have been subjected to a randomized clinical trial (RCT). This RCT studied the effectiveness of a “Grand-Aides” home visitation program in the reduction of readmissions and emergency department (ED) visits for patients with heart failure. High-risk patients (N=97) were randomized to receive care either with Grand-Aides or an established program to reduce readmissions at one hospital over two years; 85% were covered by Medicare + Medicaid (“Dual Eligibles”). Grand-Aides patients had home visits, while the control patients received telephone follow-up from community health workers. Data on all-cause readmissions and all-cause ED visits were collected at 30 and 180 days. At 6 months: patients with Grand-Aides had a 60% reduction in all-cause 6-month readmissions (65% controls and 26% Grand-Aides), p<0.001, and a 67% reduction in all-cause emergency department visits (33% controls, 11% Grand-Aides), p<0.01. For readmissions in the first 30 days, patients with Grand-Aides had a 48% reduction in readmissions (42% controls, 21.7% Grand-Aides, p=0.03) and a 79% reduction in 30-day all-cause emergency. In the first randomized clinical trial on readmissions and ED, the Grand-Aides program showed significant reductions in patients with heart failure, as compared to the best available program at the time in our health system, suggesting the impact that regular tailored home visits can have on reducing hospital resource utilization and costs. Took out sections.
VL  - 11
IS  - 2
ER  -

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Author Information

Kathleen Reeves

Lenfest Center for Community Workforce Partnerships, Temple University Health System, Philadelphia, the United States
Nicolle Strand

Center for Urban Bioethics, Lewis Katz School of Medicine, Philadelphia, the United States
Byron Udegbe

Center for Urban Bioethics, Lewis Katz School of Medicine, Philadelphia, the United States
Bryson Hoover-Hankerson

Center for Urban Bioethics, Lewis Katz School of Medicine, Philadelphia, the United States
Steuart Wright

Center for Urban Bioethics, Lewis Katz School of Medicine, Philadelphia, the United States
Victor Jegede

Center for Urban Bioethics, Lewis Katz School of Medicine, Philadelphia, the United States
Susan Freeman

ROffice of the Provost, Rush University, Chicago, the United States
Jeffrey Slocum

Lenfest Center for Community Workforce Partnerships, Temple University Health System, Philadelphia, the United States
Arthur Garson

Department of Health Systems and Population Health Sciences, College of Medicine, University of Houston, Houston, the United States

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Plain Text BibTeX RIS

APA Style

Kathleen Reeves, Nicolle Strand, Byron Udegbe, Bryson Hoover-Hankerson, Steuart Wright, et al. (2022). Grand-Aides Markedly Reduce 6-Month and 30-Day Readmissions and Emergency Department Visits for Patients with Heart Failure: A Randomized Clinical Trial. Science Journal of Clinical Medicine, 11(2), 40-44. https://doi.org/10.11648/j.sjcm.20221102.11

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ACS Style

Kathleen Reeves; Nicolle Strand; Byron Udegbe; Bryson Hoover-Hankerson; Steuart Wright, et al. Grand-Aides Markedly Reduce 6-Month and 30-Day Readmissions and Emergency Department Visits for Patients with Heart Failure: A Randomized Clinical Trial. Sci. J. Clin. Med. 2022, 11(2), 40-44. doi: 10.11648/j.sjcm.20221102.11

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AMA Style

Kathleen Reeves, Nicolle Strand, Byron Udegbe, Bryson Hoover-Hankerson, Steuart Wright, et al. Grand-Aides Markedly Reduce 6-Month and 30-Day Readmissions and Emergency Department Visits for Patients with Heart Failure: A Randomized Clinical Trial. Sci J Clin Med. 2022;11(2):40-44. doi: 10.11648/j.sjcm.20221102.11

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@article{10.11648/j.sjcm.20221102.11,
  author = {Kathleen Reeves and Nicolle Strand and Byron Udegbe and Bryson Hoover-Hankerson and Steuart Wright and Victor Jegede and Susan Freeman and Jeffrey Slocum and Arthur Garson},
  title = {Grand-Aides Markedly Reduce 6-Month and 30-Day Readmissions and Emergency Department Visits for Patients with Heart Failure: A Randomized Clinical Trial},
  journal = {Science Journal of Clinical Medicine},
  volume = {11},
  number = {2},
  pages = {40-44},
  doi = {10.11648/j.sjcm.20221102.11},
  url = {https://doi.org/10.11648/j.sjcm.20221102.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjcm.20221102.11},
  abstract = {While numerous approaches have been used to reducing hospital readmissions, few have been subjected to a randomized clinical trial (RCT). This RCT studied the effectiveness of a “Grand-Aides” home visitation program in the reduction of readmissions and emergency department (ED) visits for patients with heart failure. High-risk patients (N=97) were randomized to receive care either with Grand-Aides or an established program to reduce readmissions at one hospital over two years; 85% were covered by Medicare + Medicaid (“Dual Eligibles”). Grand-Aides patients had home visits, while the control patients received telephone follow-up from community health workers. Data on all-cause readmissions and all-cause ED visits were collected at 30 and 180 days. At 6 months: patients with Grand-Aides had a 60% reduction in all-cause 6-month readmissions (65% controls and 26% Grand-Aides), p<0.001, and a 67% reduction in all-cause emergency department visits (33% controls, 11% Grand-Aides), p<0.01. For readmissions in the first 30 days, patients with Grand-Aides had a 48% reduction in readmissions (42% controls, 21.7% Grand-Aides, p=0.03) and a 79% reduction in 30-day all-cause emergency. In the first randomized clinical trial on readmissions and ED, the Grand-Aides program showed significant reductions in patients with heart failure, as compared to the best available program at the time in our health system, suggesting the impact that regular tailored home visits can have on reducing hospital resource utilization and costs. Took out sections.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Grand-Aides Markedly Reduce 6-Month and 30-Day Readmissions and Emergency Department Visits for Patients with Heart Failure: A Randomized Clinical Trial
AU  - Kathleen Reeves
AU  - Nicolle Strand
AU  - Byron Udegbe
AU  - Bryson Hoover-Hankerson
AU  - Steuart Wright
AU  - Victor Jegede
AU  - Susan Freeman
AU  - Jeffrey Slocum
AU  - Arthur Garson
Y1  - 2022/05/12
PY  - 2022
N1  - https://doi.org/10.11648/j.sjcm.20221102.11
DO  - 10.11648/j.sjcm.20221102.11
T2  - Science Journal of Clinical Medicine
JF  - Science Journal of Clinical Medicine
JO  - Science Journal of Clinical Medicine
SP  - 40
EP  - 44
PB  - Science Publishing Group
SN  - 2327-2732
UR  - https://doi.org/10.11648/j.sjcm.20221102.11
AB  - While numerous approaches have been used to reducing hospital readmissions, few have been subjected to a randomized clinical trial (RCT). This RCT studied the effectiveness of a “Grand-Aides” home visitation program in the reduction of readmissions and emergency department (ED) visits for patients with heart failure. High-risk patients (N=97) were randomized to receive care either with Grand-Aides or an established program to reduce readmissions at one hospital over two years; 85% were covered by Medicare + Medicaid (“Dual Eligibles”). Grand-Aides patients had home visits, while the control patients received telephone follow-up from community health workers. Data on all-cause readmissions and all-cause ED visits were collected at 30 and 180 days. At 6 months: patients with Grand-Aides had a 60% reduction in all-cause 6-month readmissions (65% controls and 26% Grand-Aides), p<0.001, and a 67% reduction in all-cause emergency department visits (33% controls, 11% Grand-Aides), p<0.01. For readmissions in the first 30 days, patients with Grand-Aides had a 48% reduction in readmissions (42% controls, 21.7% Grand-Aides, p=0.03) and a 79% reduction in 30-day all-cause emergency. In the first randomized clinical trial on readmissions and ED, the Grand-Aides program showed significant reductions in patients with heart failure, as compared to the best available program at the time in our health system, suggesting the impact that regular tailored home visits can have on reducing hospital resource utilization and costs. Took out sections.
VL  - 11
IS  - 2
ER  -

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