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01-10-2019 | Bronchial Asthma | Original Research

Teach-Back Experience and Hospitalization Risk Among Patients with Ambulatory Care Sensitive Conditions: a Matched Cohort Study

Authors: Young-Rock Hong, MPH, Michelle Cardel, PhD, MS, RD, Ryan Suk, MS, Ivana A. Vaughn, PhD, MPH, Ashish A. Deshmukh, PhD, MPH, Carla L. Fisher, PhD, Gregory Pavela, PhD, Kalyani Sonawane, PhD

Published in: Journal of General Internal Medicine | Issue 10/2019

Abstract

Background

The teach-back method, also known as the “show-me” method, has been endorsed by many medical and health care societies. However, limited investigation has been conducted regarding its association with patient outcomes.

Objectives

To examine the association between patient teach-back experience and the risk of hospitalizations and length of hospital stay among patients with ambulatory care sensitive conditions (ACSCs).

Design

A matched cohort study.

Setting

Data from the 2011–2015 Longitudinal Medical Expenditure Panel Survey (panels 16–19).

Participants

Three thousand nine hundred ninety-four US adults aged ≥ 18 years with any of 5 ACSCs (hypertension, type 2 diabetes, heart disease, asthma, and chronic obstructive pulmonary disease [COPD]).

Measurements

Hospital admissions (all-cause or ACSC-related) and the length of stay of the first admission were examined by teach-back during interaction with a health provider.

Results

Patients with teach-back experience were less likely to experience hospitalization for an ACSC-related condition (relative risk, 0.85; 95% CI, 0.71 to 0.99) and had a lower risk for a condition-related readmission (hazard ratio, 0.77; 95% CI, 0.60 to 0.99), compared with those without teach-back experience. The median length of hospital stay did not differ between patients with teach-back experience and those without teach-back experience (median 3 days [IQR 1 to 8 days] and median 3 days [IQR 0 to 8 days], respectively; P = 0.84). Subgroup analysis showed that the association of reported teach-back experience on the outcomes was relatively stable among those with hypertension, diabetes, and heart disease, but was not among those with asthma or COPD.

Limitation

Teach-back exposure relied on patient self-reported information.

Conclusions

Our findings suggest that patient teach-back method is associated with reduced risk of hospitalization for those with ACSCs, especially among patients with cardiovascular diseases and type 2 diabetes. Encouraging providers to utilize the teach-back method at every visit has the potential to further reduce hospitalizations for individuals with ACSCs.

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Title: Teach-Back Experience and Hospitalization Risk Among Patients with Ambulatory Care Sensitive Conditions: a Matched Cohort Study
Authors: Young-Rock Hong, MPH
Michelle Cardel, PhD, MS, RD
Ryan Suk, MS
Ivana A. Vaughn, PhD, MPH
Ashish A. Deshmukh, PhD, MPH
Carla L. Fisher, PhD
Gregory Pavela, PhD
Kalyani Sonawane, PhD
Publication date: 01-10-2019
Publisher: Springer International Publishing
Keywords: Bronchial Asthma
Care
Chronic Obstructive Lung Disease
Published in: Journal of General Internal Medicine / Issue 10/2019
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-019-05135-y

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Abstract

Background

Objectives

Design

Setting

Participants

Measurements

Results

Limitation

Conclusions

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