Hospital in the Nursing Home program reduces emergency department presentations and hospital admissions from residential aged care facilities in Queensland, Australia: a quasi-experimental study

Fan, Lijun and Hou, Xiang-Yu and Zhao, Jingzhou and Sun, Jiandong and Dingle, Kaeleen and Purtill, Rhonda and Tapp, Sam and Lukin, Bill (2016) Hospital in the Nursing Home program reduces emergency department presentations and hospital admissions from residential aged care facilities in Queensland, Australia: a quasi-experimental study. BMC Health Services Research, 16:46. pp. 1-9. ISSN 1472-6963

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Abstract

Background
There has been considerable publicity regarding population ageing and hospital emergency department (ED) overcrowding. Our study aims to investigate impact of one intervention piloted in Queensland Australia, the Hospital in the Nursing Home (HiNH) program, on reducing ED and hospital attendances from residential aged care facilities (RACFs).

Methods
A quasi-experimental study was conducted at an intervention hospital undertaking the program and a control hospital with normal practice. Routine Queensland health information system data were extracted for analysis.

Results
Significant reductions in the number of ED presentations per 1000 RACF beds (rate ratio (95 % CI): 0.78 (0.67–0.92); p = 0.002), number of hospital admissions per 1000 RACF beds (0.62 (0.50–0.76); p < 0.0001), and number of hospital admissions per 100 ED presentations (0.61 (0.43–0.85); p = 0.004) were noticed in the experimental hospital after the intervention; while there were no significant differences between intervention and control hospitals before the intervention. Pre-test and post-test comparison in the intervention hospital also presented significant decreases in ED presentation rate (0.75 (0.65–0.86); p < 0.0001) and hospital admission rate per RACF bed (0.66 (0.54–0.79); p < 0.0001), and a non-significant reduction in hospital admission rate per ED presentation (0.82 (0.61–1.11); p = 0.196).

Conclusions
Hospital in the Nursing Home program could be effective in reducing ED presentations and hospital admissions from RACF residents. Implementation of the program across a variety of settings is preferred to fully assess the ongoing benefits for patients and any possible cost-savings.


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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Faculty/School / Institute/Centre: No Faculty
Faculty/School / Institute/Centre: No Faculty
Date Deposited: 17 Jun 2021 05:22
Last Modified: 23 Aug 2021 01:37
Uncontrolled Keywords: Emergency Department; Health Services for the aged; Hospital in Nursing Home; public hospital
Fields of Research (2008): 11 Medical and Health Sciences > 1117 Public Health and Health Services > 111706 Epidemiology
11 Medical and Health Sciences > 1117 Public Health and Health Services > 111709 Health Care Administration
11 Medical and Health Sciences > 1103 Clinical Sciences > 110305 Emergency Medicine
Fields of Research (2020): 42 HEALTH SCIENCES > 4203 Health services and systems > 420311 Health systems
42 HEALTH SCIENCES > 4203 Health services and systems > 420306 Health care administration
42 HEALTH SCIENCES > 4203 Health services and systems > 420305 Health and community services
Socio-Economic Objectives (2008): C Society > 92 Health > 9202 Health and Support Services > 920208 Health Policy Evaluation
C Society > 92 Health > 9204 Public Health (excl. Specific Population Health) > 920412 Preventive Medicine
Socio-Economic Objectives (2020): 20 HEALTH > 2004 Public health (excl. specific population health) > 200412 Preventive medicine
20 HEALTH > 2002 Evaluation of health and support services > 200206 Health system performance (incl. effectiveness of programs)
20 HEALTH > 2002 Evaluation of health and support services > 200205 Health policy evaluation
Identification Number or DOI: https://doi.org/10.1186/s12913-016-1275-z
URI: http://eprints.usq.edu.au/id/eprint/42238

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