Lian Leng Low|Farhad Fakhrudin Vasanwala|Li Choo Ng|Cynthia Chen|Kheng Hock Lee|Shaohua Tan
Effectiveness of a transitional home care program in reducing acute hospital utilization: a quasi-experimental study
Singapore General Hospital|Singapore General Hospital|Singapore General Hospital|National University Health System|National University of Singapore|Singapore General Hospital|Singapore General Hospital
improving healthcare utilization essential health systems around world grapple escalating demands acute hospital resources evidence suggests transitional care programs effective improve utilization healthcare however evidence transitional care programs enhance home medical care model provide multidisciplinary patientcentered care well established evaluated transitional home care program operated singapore general hospital effective reducing acute hospital utilization performed quasiexperimental study using prepost design evaluate effectiveness transitional home care program reducing hospital admissions emergency department attendances medically complex patients enrolled program tertiary hospital singapore patients received comprehensive needs assessment performed physician nurse case manager home setting followed individualized care plan included medical nursing care patient education coordination care hospital specialists community services primary study outcomes emergency department attendances hospital admissions hospitals extracted hospital administrative data national health records wilcoxon signed ranks test used assess differences pre post continuous data overall 262 patients enrolled program 259 analyzed patients 516 528 reduction hospital admissions threemonth sixmonth post enrollment respectively similarly 471 482 reduction observed emergency department attendances three six months post enrollment respectively average difference per patient hospital bed days pre postenrollment periods 1205 days 2003 days 3month 6month periods respectively patients enrolled transitional home care program significantly lower acute hospital utilization reduction emergency department attendances hospital admissions comprehensive assessment patients medical social needs home setting formulation individualized care plan optimized postdischarge care medically complex patients