Here - American Geriatrics Society

P OSTER
A BSTRACTS
transitions involves access to primary care which may provide better
care coordination. Our clinical practice has initiated a care transitions
program (CTP) with nurse practitioners after hospital stay in
high risk elders. The aim of this study is to evaluate the number of
primary care visits 60 days prior to enrollment and 60 days after enrollment
in CTP.
Methods: This was a retrospective cohort study of older adults
enrolled in CTP from March 2011 till September 2011. CTP was initiated
after hospital dismissal in high-risk adults over 60. Data was
collected using administrative billing data on primary care (PC) visits
prior to enrollment and after enrollment. Primary outcomes included
the percentage of people with at least one visit to the PC
team and average number of PC visits. Secondary outcomes included
visits to specialists. Analysis used McNemar test and paired t-
test respectively.
Results: 95 patients were identified who had enrolled in CTP in
mid 2011. Subjects visited their PC team 84.2% of the time before enrollment
compared to 94.74% after enrollment (p-value