Possibilities and Benefits of Intermediate Care Units in Healthcare Systems from a Logistics Perspective

Bertnum, Aili Biriita; Fragapane, Giuseppe; Semini, Marco; Strandhagen, Jan Ola

doi:10.1007/978-3-319-99704-9_33

Cited by 3 publications

(2 citation statements)

References 25 publications

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“…Many of the earlier studies of the effects of community hospitals have been small scale [31,32] or studies with methodological shortcomings [33]. However, several of the case studies found that the introduction of community hospitals and other forms of intermediate care units resulted in a reduction of unnecessary hospital admissions among older adults [31] as well as reductions in prolonged hospital stays and reduction in delayed discharges from the hospitals [34]. A US-study of a post-acute intermediate-care geriatric unit [35] indicate that such units also may represent a potential alternative to acute hospitalization for selected older patients.…”

Section: The Maws -Means To Achieve Care Integrationmentioning

confidence: 99%

The Causal Effect of Community Hospitals on General Hospital Admissions. Evaluation of a Natural Experiment Using Register Data

Hagen¹,

Tjerbo

2023

International Journal of Integrated Care

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Background: To reduce overall healthcare costs, several countries have attempted to shift services from specialist to primary care. This was also the main strategy of the Coordination Reform introduced in Norway in 2012. An important part of the reform was the introduction of Municipal Acute Wards (MAWs), a type of community hospital aimed at reducing admissions to general hospitals. The main objective of this paper is to investigate whether the implementation of MAWs had a causal effect on hospital admissions.Methods: Monthly admission rates in total and by age groups for patients admitted with acute or elective conditions at internal medicine or surgical departments were analyzed using panel data regression techniques. We identified causal effects by exploiting the sequential roll out of the MAWs within fixed effect analyses. Our data covered all municipalities from start of 2010 until the end of 2017. Results:The sequential implementation of the MAWs started during the summer of 2012. By the beginning of 2016 close to all municipalities had an operative MAW. The introduction of MAWs significantly reduced acute hospital admissions. The effect was strongest for patients ≥80 years admitted acutely to internal medicine departments. The effects were even stronger if the MAW had a physician on site 24/7 or was located close to a local emergency center. Conclusion:Our findings suggest that this type of intermediate care unit is a viable option to alleviate the burden on hospitals by reducing acute secondary care admission volumes.

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Section: The Maws -Means To Achieve Care Integrationmentioning

confidence: 99%

The Causal Effect of Community Hospitals on General Hospital Admissions. Evaluation of a Natural Experiment Using Register Data

Hagen¹,

Tjerbo

2023

International Journal of Integrated Care

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“…Interest in IMCUs has increased in both Europe and the United States. A systematic review has highlighted the positive effects of IMCUs on health systems, including reduced waiting times, improved synchronization of different medical resources, and flexible patient flow [12]. However, it also highlights the challenge of identifying this area of expertise as there is no shared understanding of this type of unit [12].…”

Section: Introductionmentioning

confidence: 99%

Utility of Intermediate Care Units: A Systematic Review Study

López-Jardón,

Martínez-Fernández,

García-Fernández

et al. 2024

Healthcare

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Intermediate care units (IMCUs) have become increasingly important in the care of critical and semi-critical patients, particularly during the COVID-19 pandemic. However, there is still no clear definition of their structural characteristics, specialties, types of patients, and the benefits they provide. The aim of this work is to describe the current state of implementation and operation of IMCUs in hospitals and patient care. To achieve this goal, a systematic review was conducted in the Web of Science, Scopus and CINAHL databases, along with a hand search. The research yielded 419 documents, of which 26 were included in this review after applying inclusion and exclusion criteria. The results were highly diverse and were categorized based on the following topics: material resources, human resources, continuity of care, and patient benefits. Despite the different objectives outlined in the studies, all of them demonstrate the numerous benefits provided by an IMCU, along with the increased relevance of this type of unit in recent years. Therefore, this systematic review highlights the benefits of IMCUs in the care of critical patients, as well as the role of health workers in these units.

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Return to work after hospitalization for sepsis: a nationwide, registry-based cohort study

Skei,

Moe,

Nilsen

et al. 2023

Crit Care

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Background Sepsis survivors commonly experience functional impairment, which may limit return to work. We investigated return to work (RTW) of patients hospitalized with sepsis and the associations with patient and clinical characteristics. Methods Working-age patients (18–60 years) admitted to a Norwegian hospital with sepsis between 2010 and 2021 were identified using the Norwegian Patient Registry and linked to sick-leave data from the Norwegian National Social Security System Registry. The main outcome was proportion of RTW in patients hospitalized with sepsis at 6 months, 1 year, and 2 years after discharge. Secondary outcomes were time trends in age-standardized proportions of RTW and probability of sustainable RTW (31 days of consecutive work). The time trends were calculated for each admission year, reported as percentage change with 95% confidence interval (CI). Time-to-event analysis, including crude and adjusted hazard risk (HRs), was used to explore the association between sustainable RTW, characteristics and subgroups of sepsis patients (intensive care unit (ICU) vs. non-ICU and COVID-19 vs. non-COVID-19). Results Among 35.839 hospitalizations for sepsis among patients aged 18–60 years, 12.260 (34.2%) were working prior to hospitalization and included in this study. The mean age was 43.7 years. At 6 months, 1 year, and 2 years post-discharge, overall estimates showed that 58.6%, 67.5%, and 63.4%, respectively, were working. The time trends in age-standardized RTW for ICU and non-ICU sepsis patients remained stable over the study period, except the 2-year age-standardized RTW for non-ICU patients that declined by 1.51% (95% CI − 2.22 to − 0.79) per year, from 70.01% (95% CI 67.21 to 74.80) in 2010 to 57.04% (95% CI 53.81–60.28) in 2019. Characteristics associated with sustainable RTW were younger age, fewer comorbidities, and fewer acute organ dysfunctions. The probability of sustainable RTW was lower in ICU patients compared to non-ICU patients (HR 0.56; 95% CI 0.52–0.61) and higher in patients with COVID-19-related sepsis than in sepsis patients (HR 1.31; 95% CI 1.15–1.49). Conclusion Absence of improvement in RTW proportions over time and the low probability of sustainable RTW in sepsis patients need attention, and further research to enhance outcomes for sepsis patients is required.

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Possibilities and Benefits of Intermediate Care Units in Healthcare Systems from a Logistics Perspective

Cited by 3 publications

References 25 publications

The Causal Effect of Community Hospitals on General Hospital Admissions. Evaluation of a Natural Experiment Using Register Data

The Causal Effect of Community Hospitals on General Hospital Admissions. Evaluation of a Natural Experiment Using Register Data

Utility of Intermediate Care Units: A Systematic Review Study

Return to work after hospitalization for sepsis: a nationwide, registry-based cohort study

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