Hospital treatment in residential care facilities is a viable alternative to hospital admission for selected patients

Abstract

Aim: To determine if hospital treatment in residential care facilities, led by a geriatric team, might be a viable alternative to inpatient admission for selected patients. Methods: Case series with a new intervention were compared with historical controls receiving the conventional treatment. Treatment in residential care facilities (TRC) by the Residential Care Intervention Program in The Elderly (RECIPE) service was compared against the conventional treatment group, aged care unit (ACU) inpatients. Results: A total of 95 patients in TRC and 167 patients in ACU were included. The mean Charlson Comorbidity Index score was 7 in both groups and demographics were similar, except more patients in the TRC group had dementia. Palliative care support was provided to 35.8% in the TRC group, compared with 7.8% in ACU, P < 0.001. Six‐month mortality rates were similar at 30% for both groups. Rehospitalization rates at 6 months were similar at 41% for both groups. Length of care was significantly shorter for TRC (mean 2 days) compared with ACU (mean 11 days), P < 0.001. Conclusions: Hospital treatment in residential care is viable for most patients, including those with dementia and those who need palliative care support. This model of care offers a valuable geriatric service to residents who would prefer to avoid hospital transfers, with no difference in mortality or rehospitalization rates for those treated in residential care, but a significant reduction in length of care. Geriatr Gerontol Int 2013; 13: 378–383.

Safety and effectiveness of ‘hospital in the home’ and ‘outpatient parenteral antimicrobial therapy’ in different age groups: A systematic review of observational studies

“…Lau et al compared outcomes of treatment in residential care and hospital inpatient treatment at different periods and found that treatment in residential care is a viable alternative for hospital treatment. However, in this study, hospital and home treatment groups were selected at different periods and hence time‐based factors could have affected the results.…”

“…For example, the study performed by Liu and McD Taylor used adverse events as defined by Harvard Medical Practice Study, whereas other studies defined adverse events as complications occurring related to VAD, pumps or drugs. A few studies considered 1 month after discharge for readmissions and mortality, some considered only during the treatment period and others considered 1 month or during therapy . These differences in reporting may contribute to the major differences in readmission, adverse events or mortality rates between studies.…”

“…Numerous studies assessing the adverse events (AEs) and effectiveness of HITH and OPAT have been performed in many countries including Australia, USA, UK, Spain, France, Singapore, Israel, Canada, Italy, Ireland, New Zealand, Saudi Arabia, Switzerland and Greece . Some studies have analysed the safety of HITH or OPAT for a particular disease or for a particular group including geriatric or paediatric patients …”

“…Numerous studies assessing the adverse events (AEs) and effectiveness of HITH and OPAT have been performed in many countries including Australia, 2,9,[19][20][21][22][23][24][25][26] USA, [27][28][29][30][31][32][33][34][35][36][37][38][39][40] UK, 4,[41][42][43][44][45] Spain, 3,8,11,15,46 France, 47,48 Singapore, 12,49 Israel, 50 Canada, 51 Italy, 17 Ireland, 52 New Zealand, 53 Saudi Arabia, 54 Switzerland 55 and Greece. 56 Some studies have analysed the safety of HITH or OPAT for a particular disease or for a particular group including geriatric 11,15,17,…”

Optimising healthcare ICT support for the care and management of elderly adults with mental illness in residential aged care facilities

“…Recent mental illness research concentrates on different areas that relate to the treatment of dementia such as: evidence-based practice (Lau et al, 2013;Nicholls et al, 2013;Ploeg et al, 2007;Stetler et al, 2009;Van Achterberg et al, 2008), educational aspects (Jeon et al, 2013), family involvement (Petriwskyj et al, 2014;Vreugdenhil, 2014), and funding impact and incentives (Jeon et al, 2013). However, there is a gap in research that focus on individual, customised aged care treatment care plans for mentally ill adults.…”