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A longitudinal cohort study evaluating the impact of a geriatrician-led residential care out-reach service on acute health care utilisation

Hutchinson, AF, Parikh, S, Tacey, M, Harvey, P and Lim, WK 2014, A longitudinal cohort study evaluating the impact of a geriatrician-led residential care out-reach service on acute health care utilisation, Age and ageing, vol. 44, no. 2, pp. 365-370, doi: 10.1093/ageing/afu196.

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Title A longitudinal cohort study evaluating the impact of a geriatrician-led residential care out-reach service on acute health care utilisation
Author(s) Hutchinson, AFORCID iD for Hutchinson, AF orcid.org/0000-0001-5065-2726
Parikh, S
Tacey, M
Harvey, P
Lim, WK
Journal name Age and ageing
Volume number 44
Issue number 2
Start page 365
End page 370
Total pages 6
Publisher Oxford University Press
Place of publication Oxford, United Kingdom
Publication date 2014-12-23
ISSN 1468-2834
Keyword(s) Geriatrician out-reach teams
Aged Care Nursing
Nursing outreach
Residential Aged Care Facilities
Advance Care Plans
Summary Background: Over the last decade, high demand for acute health care services by long-term residents of residential care facilities (RCF) has stimulated interest in exploring alternative models of care. The Residential Care Intervention Program in the Elderly (RECIPE) service provides expert outreach services to RCFs residents, interventions include: comprehensive care planning, management of intercurrent illness and rapid access to acute care substitution services.Objective: To evaluate whether the RECIPE service decreased acute health care utilisation.Design: A retrospective cohort study using interrupted time series analysis to analyse change in acute healthcare utilisation before and after enrolment.Setting: A 300 bed metropolitan teaching hospital in Australia and 73 RCF within its catchment.Subjects: There were 1327 patients enrolled in the service with a median age 84 years, 61% were female. Methods: Data was collected prospectively on all enrolled patients from 2004 to 2011 and linked to the acute health service administrative dataset. Primary outcomes change in admission rates, length of stay and beddays per quarter.Results: In the two years prior to enrolment the mean number of acute care admissions per patient per year was 3.03 (SD 2.9) versus post 2.4 (SD 3.3), the service reducing admissions by 0.13 admissions per patient per quarter (p=0.046). Prior to enrolment the mean length of stay was 8.6 (SD 11.0) versus post 3.5 (SD 5.0), a reduction of 1.5 days per patient per quarter (p=0.003). Conclusions:This study suggests that an outreach service comprising a geriatrician-led multidisciplinary team can reduce acute hospital utilisation rates.
Language eng
DOI 10.1093/ageing/afu196
Field of Research 111001 Aged Care Nursing
110308 Geriatrics and Gerontology
Socio Economic Objective 920112 Neurodegenerative Disorders Related to Ageing
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2014, Oxford University Press
Persistent URL http://hdl.handle.net/10536/DRO/DU:30070188

Document type: Journal Article
Collection: School of Nursing and Midwifery
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