Comparison of effects between home visits with telephone calls and telephone calls only for transitional discharge support: a randomised controlled trial

Age Ageing. 2014 Jan;43(1):91-7. doi: 10.1093/ageing/aft123. Epub 2013 Aug 26.


Background: home visits and telephone calls are two often used approaches in transitional care but their differential effects are unknown.

Objective: to examine the overall effects of a transitional care programme for discharged medical patients and the differential effects of telephone calls only.

Design: randomised controlled trial.

Setting: a regional hospital in Hong Kong.

Participants: patients discharged from medical units fitting the inclusion criteria (n = 610) were randomly assigned to: control ('control', n = 210), home visits with calls ('home', n = 196) and calls only ('call', n = 204).

Intervention: the home groups received alternative home visits and calls and the call groups calls only for 4 weeks. The control group received two placebo calls. The nurse case manager was supported by nursing students in delivering the interventions.

Results: the home visit group (after 4 weeks 10.7%, after 12 weeks 21.4%) and the call group (11.8, 20.6%) had lower readmission rates than the control group (17.6, 25.7%). Significance differences were detected in intention-to-treat (ITT) analysis for the home and intervention group (home and call combined) at 4 weeks. In the per-protocol analysis (PPA) results, significant differences were found in all groups at 4 weeks. There was significant improvement in quality of life, self-efficacy and satisfaction in both ITT and PPA for the study groups.

Conclusions: this study has found that bundled interventions involving both home visits and calls are more effective in reducing readmissions. Many of the transitional care programmes use all-qualified nurses, and this study reveals that a mixed skills model seems to bring about positive effects as well.

Keywords: home visits; hospital readmissions; older people; telephone calls; transitional discharge support.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Continuity of Patient Care*
  • Female
  • Home Health Nursing*
  • Hong Kong
  • Hospitals, General
  • House Calls*
  • Humans
  • Intention to Treat Analysis
  • Male
  • Patient Care Bundles*
  • Patient Discharge*
  • Patient Readmission
  • Patient Satisfaction
  • Quality of Life
  • Self Efficacy
  • Telephone*
  • Time Factors
  • Treatment Outcome