Hospital discharge planning and continuity of care for aged people in an Italian local health unit: does the care-home model reduce hospital readmission and mortality rates?

<p>Abstract</p> <p>Background</p> <p>Hospital discharge planning is aimed to decrease length of stay in hospitals as well as to ensure continuity of health care after being discharged. Hospitalized patients in Turin, Italy, who are in need of medical, social and rehabilitative care are proposed as candidates to either discharge planning relying on a care-home model (DPCH) for a period of about 30 days, or routine discharge care. The aim of this study was to evaluate whether a hospital DPCH that was compared with routine care, improved patients' outcomes in terms of reduced hospital readmission and mortality rates in patients aged 64 years and older.</p> <p>Methods</p> <p>In a retrospective observational cohort study a sample of 380 subjects aged 64 years and over was examined. Participants were discharged from the hospital S.Giovanni Bosco in Turin, Italy from March 1^st, 2005 to February 28^th, 2006. Of these subjects, 107 received routine discharge care while 273 patients were referred to care-home (among them, 99 received a long-term care intervention (LTCI) afterwards while 174 did not). Data was gathered from various administrative and electronic databases. Cox regression models were used to evaluate factors associated with mortality and hospital readmission.</p> <p>Results</p> <p>When socio-demographic factors, underlying disease and disability were taken into account, DPCH decreased mortality rates only if it was followed by a LTCI: compared to routine care, the Hazard Ratio (HR) of death was 0.36 (95% Confidence Interval (CI): 0.20 – 0.66) and 1.15 (95%CI: 0.77 – 1.74) for DPCH followed by LTCI and DPCH not followed by LTCI, respectively. On the other hand, readmission rates did not significantly differ among DPCH and routine care, irrespective of the implementation of a LTCI: HRs of hospital readmission were 1.01 (95%CI: 0.48 – 2.24) and 1.18 (95%CI: 0.71 – 1.96), respectively.</p> <p>Conclusion</p> <p>The use of DPCH after hospital discharge reduced mortality rates, but only when it was followed by a long-term health care plan, thus ensuring continuity of care for elderly participants.</p

Revelando sentidos na prática docente:A abordagem de corpus na análise do discurso

This paper discusses the feasibility of using Corpus Linguistics tools in the analysis of pedagogic discourse. For doing this, two case studies are presented. The first one focuses on the discourse of English language teachers of a well-known languages course in Rio de Janeiro about the implementation of technological resources in the classroom. The second study, in its turn, seeks to realize the position held by university professors of literatures in English language with regard to literature and its teaching. The results point out to the richness of contextual data which can be inferred from a linguistic analysis with an empirical basis. All in all, the paper uncovers the importance and flexibility of the corpus approach in discourse analysis, which may be applied to several contexts