Seok M Lim1, Louis Island1, Adam Horsburgh2, Andrea B Maier3. 1. Department of Medicine and Aged Care, @AgeMelbourne, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia. 2. The Royal Melbourne Hospital, Parkville, Victoria, Australia. 3. Department of Medicine and Aged Care, @AgeMelbourne, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands. Electronic address: andrea.maier@unimelb.edu.au.
Abstract
OBJECTIVES: To determine the proportion of hospitalized inpatients suitable for an acute and subacute home-based inpatient bed substitutive service, to examine the ability of treating teams to identify suitable patients for this service, and to examine potential barriers toward inpatients receiving home-based care. DESIGN: Prospective point prevalence study over 2 days in April 2019; analysis of responses to survey questionnaires regarding the suitability for home-based care among inpatients with multiday admissions to acute and subacute wards in the Royal Melbourne Hospital (RMH), an Australian metropolitan tertiary referral center. SETTING AND PARTICIPANTS: Ward treating teams, clinicians affiliated with the home-based service called RMH@Home, and inpatients who were subsequently identified as being suitable for home-based care. MEASUREMENTS: Point prevalence and characteristics of inpatients suitable for a home-based bed substitutive service; identified by either treating teams or RMH@Home clinicians; and barriers to the provision of home-based care among ward inpatients. RESULTS: Survey responses were received for 620 of 635 inpatients [median age 69 years (interquartile range 53-81), 53% male], of which 69 (11.1%) were identified as being suitable for home-based inpatient bed substitution care. Treating team clinicians identified 26 patients, clinicians affiliated with RMH@Home identified a further 43 suitable patients. The most commonly reported barrier (38.1%) toward receiving home-based care was functional disability impeding ability to live at home. CONCLUSIONS AND IMPLICATIONS: A substantial proportion of hospitalized older patients could use home-based inpatient bed substitutive services. Clinicians experienced in home-based care are more skilled than ward-based clinicians in identifying suitable patients for this care model.
OBJECTIVES: To determine the proportion of hospitalized inpatients suitable for an acute and subacute home-based inpatient bed substitutive service, to examine the ability of treating teams to identify suitable patients for this service, and to examine potential barriers toward inpatients receiving home-based care. DESIGN: Prospective point prevalence study over 2 days in April 2019; analysis of responses to survey questionnaires regarding the suitability for home-based care among inpatients with multiday admissions to acute and subacute wards in the Royal Melbourne Hospital (RMH), an Australian metropolitan tertiary referral center. SETTING AND PARTICIPANTS: Ward treating teams, clinicians affiliated with the home-based service called RMH@Home, and inpatients who were subsequently identified as being suitable for home-based care. MEASUREMENTS: Point prevalence and characteristics of inpatients suitable for a home-based bed substitutive service; identified by either treating teams or RMH@Home clinicians; and barriers to the provision of home-based care among ward inpatients. RESULTS: Survey responses were received for 620 of 635 inpatients [median age 69 years (interquartile range 53-81), 53% male], of which 69 (11.1%) were identified as being suitable for home-based inpatient bed substitution care. Treating team clinicians identified 26 patients, clinicians affiliated with RMH@Home identified a further 43 suitable patients. The most commonly reported barrier (38.1%) toward receiving home-based care was functional disability impeding ability to live at home. CONCLUSIONS AND IMPLICATIONS: A substantial proportion of hospitalized older patients could use home-based inpatient bed substitutive services. Clinicians experienced in home-based care are more skilled than ward-based clinicians in identifying suitable patients for this care model.
Authors: Paula M Loveland; Esmee M Reijnierse; Louis Island; Wen Kwang Lim; Andrea B Maier Journal: J Am Geriatr Soc Date: 2022-02-04 Impact factor: 7.538