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Table 2 Frequency of measured items using the original group of patients (N=24)

From: Evaluation of a modified community based care transitions model to reduce costs and improve outcomes

 

Total Number

Percent

Reported averted care visits (hospital or office)

11

45.8

Appointment assistance

10

41.7

Follow up appointment(s) scheduled

21

87.5

Transportation to appointment(s) in place

20

83.3

Follow up scheduled within 7 days

10

41.7

Follow up scheduled with specialist

19

79.2

Medication reconciliation

21

87.5

Medication education

21

87.5

Education on condition red flags

22

91.7

Education on condition specific information

22

91.7

Received individualized care plan

22

91.7

Hospital A referrals

12

50

Hospital B referrals

12

50

Reported unplanned care visits

5

20.8

Depression screening completed

10

41.7

Mobility screening completed

10

41.7