Siobhán McGettigan1, Amy Farrell1, Robert Murphy1, Conall MacGearailt1, Shaun T O'Keeffe2, Eamon C Mulkerrin1. 1. Department of Geriatric Medicine, University Hospital, Unit 4, Merlin Park University Hospital, Galway, Republic of Ireland. 2. Department of Geriatric Medicine, University Hospital, Unit 4, Merlin Park University Hospital, Galway, Republic of Ireland. sokeeffeanc@gmail.com.
Abstract
PURPOSE: To determine the effectiveness of a post-acute care scheme by exploiting a natural experiment. METHODS: We used a reduction in funding for an Irish PAC scheme based in private nursing homes as a natural experiment to explore the effectiveness of this scheme in a single large general hospital. RESULTS: Compared with an equivalent 3-month period in 2017 (pre-change, N = 169), those admitted to PAC in 2019 (post-change, N = 179), spent a median 6 days longer in acute care, although total duration spent in healthcare settings was the same. Compared with 2017, readmissions to hospital within 90 days of discharge (43/179 (24.0% v 58/169 (34.3%), p = 0.03) and discharge to long-term care from the PAC facility (3 (1.7%) v 14 (8.3%), p = 0.004) were significantly lower in 2019. CONCLUSION: Our results suggest that the longer stay in acute care and shorter stay in PAC was beneficial for patients and led to improved outcomes.
PURPOSE: To determine the effectiveness of a post-acute care scheme by exploiting a natural experiment. METHODS: We used a reduction in funding for an Irish PAC scheme based in private nursing homes as a natural experiment to explore the effectiveness of this scheme in a single large general hospital. RESULTS: Compared with an equivalent 3-month period in 2017 (pre-change, N = 169), those admitted to PAC in 2019 (post-change, N = 179), spent a median 6 days longer in acute care, although total duration spent in healthcare settings was the same. Compared with 2017, readmissions to hospital within 90 days of discharge (43/179 (24.0% v 58/169 (34.3%), p = 0.03) and discharge to long-term care from the PAC facility (3 (1.7%) v 14 (8.3%), p = 0.004) were significantly lower in 2019. CONCLUSION: Our results suggest that the longer stay in acute care and shorter stay in PAC was beneficial for patients and led to improved outcomes.
Authors: Duygu Sezgin; Rónán O'Caoimh; Aaron Liew; Mark R O'Donovan; Maddelena Illario; Mohamed A Salem; Siobhán Kennelly; Ana María Carriazo; Luz Lopez-Samaniego; Cristina Arnal Carda; Rafael Rodriguez-Acuña; Marco Inzitari; Teija Hammar; Anne Hendry Journal: Eur Geriatr Med Date: 2020-08-04 Impact factor: 1.710