{"id":"https://openalex.org/W2298310772","doi":null,"title":"Reducing preventable hospitalizations: a study of two models of transitional care","display_name":"Reducing preventable hospitalizations: a study of two models of transitional care","publication_year":2016,"publication_date":"2016-01-01","ids":{"openalex":"https://openalex.org/W2298310772","mag":"2298310772"},"language":"en","primary_location":{"id":"pmh:oai:scholarworks.uvm.edu:graddis-1467","doi":null,"is_oa":true,"landing_page_url":"https://scholarworks.uvm.edu/graddis/468","pdf_url":"https://scholarworks.uvm.edu/cgi/viewcontent.cgi?article=1467&context=graddis","source":{"id":"https://openalex.org/S4377196529","display_name":"ScholarWorks -A service of University of Vermont Libraries (University of Vermont)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I111236770","host_organization_name":"University of Vermont","host_organization_lineage":["https://openalex.org/I111236770"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Graduate College Dissertations and Theses","raw_type":"text"},"volume":null,"type":"article","is_traditional":true,"indexed_in":[],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://scholarworks.uvm.edu/cgi/viewcontent.cgi?article=1467&context=graddis","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":null,"display_name":"Jessica M. Morrison","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Jessica M. Morrison","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":0,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":1,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":88,"max":93},"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T12174","display_name":"Hospital Admissions and Outcomes","score":0.9648000001907349,"subfield":{"id":"https://openalex.org/subfields/2911","display_name":"Leadership and Management"},"field":{"id":"https://openalex.org/fields/29","display_name":"Nursing"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T12174","display_name":"Hospital Admissions and Outcomes","score":0.9648000001907349,"subfield":{"id":"https://openalex.org/subfields/2911","display_name":"Leadership and Management"},"field":{"id":"https://openalex.org/fields/29","display_name":"Nursing"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12246","display_name":"Chronic Disease Management Strategies","score":0.012199999764561653,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11376","display_name":"Geriatric Care and Nursing Homes","score":0.0038999998942017555,"subfield":{"id":"https://openalex.org/subfields/2717","display_name":"Geriatrics and Gerontology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/care-transitions","display_name":"care transitions","score":0.9980000257492065},{"id":"https://openalex.org/keywords/avoidable-hospitalizations","display_name":"avoidable hospitalizations","score":0.9010000228881836},{"id":"https://openalex.org/keywords/emergency-department-visits","display_name":"emergency department visits","score":0.7860000133514404},{"id":"https://openalex.org/keywords/clinical-nurse-specialists","display_name":"clinical nurse specialists","score":0.7480000257492065},{"id":"https://openalex.org/keywords/palliative-care","display_name":"palliative care","score":0.9079999923706055},{"id":"https://openalex.org/keywords/chronic-disease-self-management","display_name":"chronic disease self-management","score":0.9190000295639038},{"id":"https://openalex.org/keywords/post-discharge-follow-up","display_name":"post-discharge follow-up","score":0.7990000247955322},{"id":"https://openalex.org/keywords/home-visits","display_name":"home visits","score":0.8610000014305115},{"id":"https://openalex.org/keywords/health-care-utilization","display_name":"health care utilization","score":0.8330000042915344},{"id":"https://openalex.org/keywords/older-adults","display_name":"older adults","score":0.734000027179718}],"concepts":[{"id":"https://openalex.org/C2779685841","wikidata":"https://www.wikidata.org/wiki/Q7834462","display_name":"Transitional care","level":3,"score":0.6082996129989624},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.41273564100265503},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.35349029302597046},{"id":"https://openalex.org/C545542383","wikidata":"https://www.wikidata.org/wiki/Q2751242","display_name":"Medical emergency","level":1,"score":0.3422206938266754},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.33528709411621094},{"id":"https://openalex.org/C112930515","wikidata":"https://www.wikidata.org/wiki/Q4389547","display_name":"Risk analysis (engineering)","level":1,"score":0.3343145549297333},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.32018017768859863},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.1421513855457306},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.13401582837104797}],"mesh":[],"locations_count":3,"locations":[{"id":"pmh:oai:scholarworks.uvm.edu:graddis-1467","doi":null,"is_oa":true,"landing_page_url":"https://scholarworks.uvm.edu/graddis/468","pdf_url":"https://scholarworks.uvm.edu/cgi/viewcontent.cgi?article=1467&context=graddis","source":{"id":"https://openalex.org/S4377196529","display_name":"ScholarWorks -A service of University of Vermont Libraries (University of Vermont)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I111236770","host_organization_name":"University of Vermont","host_organization_lineage":["https://openalex.org/I111236770"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Graduate College Dissertations and Theses","raw_type":"text"},{"id":"pmh:oai:scholarworks.uvm.edu:20.500.14849/4431","doi":null,"is_oa":false,"landing_page_url":"https://hdl.handle.net/20.500.14849/4431","pdf_url":null,"source":{"id":"https://openalex.org/S4377196529","display_name":"ScholarWorks -A service of University of Vermont Libraries (University of Vermont)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I111236770","host_organization_name":"University of Vermont","host_organization_lineage":["https://openalex.org/I111236770"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"thesis"},{"id":"mag:2298310772","doi":null,"is_oa":false,"landing_page_url":"https://scholarworks.uvm.edu/cgi/viewcontent.cgi?article=1467&context=graddis","pdf_url":null,"source":null,"license":null,"license_id":null,"version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":null}],"best_oa_location":{"id":"pmh:oai:scholarworks.uvm.edu:graddis-1467","doi":null,"is_oa":true,"landing_page_url":"https://scholarworks.uvm.edu/graddis/468","pdf_url":"https://scholarworks.uvm.edu/cgi/viewcontent.cgi?article=1467&context=graddis","source":{"id":"https://openalex.org/S4377196529","display_name":"ScholarWorks -A service of University of Vermont Libraries (University of Vermont)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I111236770","host_organization_name":"University of Vermont","host_organization_lineage":["https://openalex.org/I111236770"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Graduate College Dissertations and Theses","raw_type":"text"},"sustainable_development_goals":[{"score":1.0,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W2298310772.pdf","grobid_xml":"https://content.openalex.org/works/W2298310772.grobid-xml"},"referenced_works_count":64,"referenced_works":["https://openalex.org/W91749409","https://openalex.org/W287407794","https://openalex.org/W1546824020","https://openalex.org/W1571788998","https://openalex.org/W1592983081","https://openalex.org/W1937573170","https://openalex.org/W1967137702","https://openalex.org/W1970312404","https://openalex.org/W1971273866","https://openalex.org/W1973132226","https://openalex.org/W1975934486","https://openalex.org/W1981400547","https://openalex.org/W1982768347","https://openalex.org/W1985118181","https://openalex.org/W1993752298","https://openalex.org/W1994256263","https://openalex.org/W1994339511","https://openalex.org/W1995884084","https://openalex.org/W2016791343","https://openalex.org/W2018698711","https://openalex.org/W2021231043","https://openalex.org/W2029304517","https://openalex.org/W2030090349","https://openalex.org/W2030114189","https://openalex.org/W2032063546","https://openalex.org/W2040562378","https://openalex.org/W2041805809","https://openalex.org/W2046731543","https://openalex.org/W2047121685","https://openalex.org/W2054085905","https://openalex.org/W2054589262","https://openalex.org/W2059212936","https://openalex.org/W2062040602","https://openalex.org/W2073674312","https://openalex.org/W2081245992","https://openalex.org/W2083604329","https://openalex.org/W2087613811","https://openalex.org/W2089091745","https://openalex.org/W2100673063","https://openalex.org/W2102511801","https://openalex.org/W2103770110","https://openalex.org/W2104461281","https://openalex.org/W2108517568","https://openalex.org/W2108811102","https://openalex.org/W2109052610","https://openalex.org/W2112334854","https://openalex.org/W2121242948","https://openalex.org/W2133584801","https://openalex.org/W2136761059","https://openalex.org/W2139121045","https://openalex.org/W2140121000","https://openalex.org/W2140732276","https://openalex.org/W2142107083","https://openalex.org/W2142238675","https://openalex.org/W2151494497","https://openalex.org/W2154686997","https://openalex.org/W2154734473","https://openalex.org/W2164510796","https://openalex.org/W2170131723","https://openalex.org/W2171322201","https://openalex.org/W2187965899","https://openalex.org/W2296296657","https://openalex.org/W2314331676","https://openalex.org/W2779034663"],"related_works":["https://openalex.org/W2338934772","https://openalex.org/W2357030208","https://openalex.org/W4403811437","https://openalex.org/W3160760063","https://openalex.org/W2007719091","https://openalex.org/W2151494497","https://openalex.org/W4247280918","https://openalex.org/W2947245534","https://openalex.org/W4389264383","https://openalex.org/W2987343986"],"abstract_inverted_index":{"Purpose:":[0],"Transitional":[1],"care":[2,9,37,60,68,93,98,135,291,335],"is":[3,40,105,318,349],"an":[4,222],"emerging":[5],"model":[6],"of":[7,19,34,88,91,113,177,225,239,250,326,344,346],"health":[8,97,290],"designed":[10],"to":[11,197,255,266,320,332,339],"decrease":[12],"preventable":[13],"adverse":[14],"events":[15],"and":[16,32,79,118,125,154,156,181,209,227],"associated":[17],"utilization":[18],"healthcare":[20,328],"through":[21],"temporary":[22],"follow-up":[23],"after":[24,126,206],"hospital":[25],"discharge.":[26],"This":[27,104],"study":[28,109,313,338],"describes":[29],"the":[30,89,111,121,127,165,192,207,212,218,233,245,273,309,327,341,347],"approach":[31],"outcomes":[33],"two":[35],"transitional":[36,67,92,134,284,334],"programs:":[38],"one":[39],"provided":[41],"by":[42,55,96],"masters-prepared":[43],"clinical":[44],"nurse":[45],"specialists":[46],"(CNS)":[47],"with":[48,70,314],"a":[49,106,236,248,297,323],"chronic":[50],"disease":[51,150],"self-management":[52],"focus,":[53],"another":[54],"physicians":[56],"specializing":[57],"in":[58,120,132,146,164,217,272,288],"palliative":[59],"(PPC).":[61],"Existing":[62],"research":[63],"has":[64],"shown":[65],"that":[66],"programs":[69,94,285],"intensive":[71],"follow":[72],"up":[73],"reduce":[74],"hospitalizations,":[75],"emergency":[76],"room":[77],"visits,":[78,142],"costs.":[80],"Few":[81],"studies,":[82],"however,":[83],"have":[84,286],"included":[85,139,144,216],"side-by-side":[86],"comparisons":[87],"efficacy":[90],"varying":[95],"providers":[99],"or":[100],"program":[101,138,147,167,194],"focus.":[102],"Design:":[103],"retrospective":[107],"cohort":[108],"comparing":[110],"number":[112],"Emergency":[114],"Department":[115],"(ED)":[116],"visits":[117,280,303],"hospitalizations":[119],"120":[122,204],"days":[123,205],"before":[124],"intervention":[128,208,275,295],"for":[129,268,304,322],"patients":[130,190],"enrolled":[131],"each":[133,345],"program.":[136,311],"Each":[137],"post-hospitalization":[140],"home":[141],"but":[143],"difference":[145],"focus":[148],"(chronic":[149],"vs.":[151,159],"palliative),":[152],"assessment":[153],"interventions,":[155],"population":[157,307],"(rural":[158],"urban).":[160],"Data":[161,186],"from":[162,189,191,195],"participants":[163,178,201],"CNS":[166,234,274,294],"9/2014":[168,196],"'":[169],"12/2014":[170],"were":[171,183,210,215,228],"analyzed":[172],"(n=98).":[173],"The":[174,293],"average":[175,223],"age":[176,224],"was":[179,187,242,253,264],"69":[180],"they":[182],"65%":[184],"female.":[185,230],"collected":[188],"PC":[193,246,310],"4/2015":[198],"(n=71).":[199],"Thirty":[200],"died":[202],"within":[203],"excluded,":[211],"remaining":[213],"41":[214],"analysis.":[219],"Participants":[220],"had":[221,276,296],"81":[226],"63%":[229],"Methods:":[231],"For":[232,244],"program,":[235,247],"secondary":[237],"analysis":[238],"existing":[240],"data":[241],"performed.":[243],"review":[249],"patient":[251],"charts":[252],"done":[254],"collect":[256],"encounters":[257],"data.":[258],"A":[259],"Wilcoxon":[260],"Matched-Pair":[261],"Signed-Rank":[262],"test":[263,267],"performed":[265],"significance.":[269],"Findings:":[270],"Patients":[271],"significantly":[277],"fewer":[278],"ED":[279,302],"(p":[281],"Conclusions:":[282],"Both":[283],"value":[287],"decreasing":[289],"utilization.":[292],"more":[298],"significant":[299],"effect":[300],"on":[301],"their":[305],"target":[306],"than":[308],"Further":[312],"randomized":[315],"control":[316],"trails":[317],"needed":[319],"allow":[321],"better":[324],"understanding":[325],"workforce":[329],"best":[330],"fitted":[331],"enhance":[333],"outcomes.":[336],"Future":[337],"examine":[340],"cost":[342],"savings":[343],"interventions":[348],"also":[350],"needed.":[351]},"counts_by_year":[{"year":2024,"cited_by_count":1}],"updated_date":"2026-11-07T11:25:07.637180","created_date":"2016-06-24T00:00:00"}