Presentation of Evidence (Essay Sample)

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 e...