Effect of Video Call Follow-up at Chulabhorn Hospital on Readmission Rates in Metastatic Cancer Patients after Palliative Care

Abstract

Background: Metastatic cancer patients often require palliative care to alleviate symptoms and preserve quality of life. Nevertheless, unplanned hospital readmissions remain a significant concern, suggesting potential gaps in continuity of care and post-discharge support. Objective: To evaluate the effectiveness of video call follow-up using the Chulabhorn Assessment Form in enhancing patient self-care and reducing unplanned hospital readmissions among metastatic cancer patients after palliative care. Materials and Methods: A descriptive, prospective cohort study was conducted at Chulabhorn Hospital between July 2023 and January 2024. One hundred eighty metastatic cancer patients were enrolled. Video call follow-ups were conducted on days one, seven, and twenty-eight post-discharge to provide emotional support, assess symptoms, and encourage self-care. Variables such as distress scores and previous unplanned readmissions were analyzed using logistic regression. Results: Patients with a history of unplanned readmissions were significantly more likely to be readmitted within 28 days, even with video call follow-up (adjusted OR 11.13, 95% CI 4.38 to 28.27, p<0.001). High distress scores, of 4 or greater, were also strongly associated with increased readmission risk (p<0.001). While video calls enabled nurses to assess patients' home environments and provide timely advice, certain high-risk patients remained vulnerable to readmission. Conclusion: Video call follow-up using the Chulabhorn Assessment Form provides valuable insights into patients' needs and supports self-care. However, it alone is insufficient to prevent hospital readmissions in all cases. Targeted interventions for high-risk patients are essential. Nurses play a crucial role in identifying these patients and delivering individualized post-discharge care.