An outcomes evaluation of an Australian Hospital in the Nursing Home admission avoidance programme
An outcomes evaluation of an Australian Hospital in the Nursing Home admission avoidance programme
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DOI：
10.1111/j.1365-2702.2010.03371.x
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发表时间：
2011-04-01
影响因子：
4.2
通讯作者：
Polit, Denise
中科院分区：
文献类型：
--
作者：
Crilly, Julia;Chaboyer, Wendy;Polit, Denise
目的和目标：对疗养院(HINH)中的一家医院进行避免入院计划的结果评估。背景：避免入院类型的服务，如家庭医院，在改善某些人群的服务提供方面有一席之地。有关HINH的研究有限，来自国际上各种不同的医疗保健系统，结果各不相同。设计：在一家地区性医院进行了一项准实验研究。将从两个不同的数据源常规收集的卫生信息系统数据链接起来进行分析。方法：根据三个特征(年龄、性别和诊断类别)将干预组患者与对照组进行匹配。对其他可能影响患者住院结果和住院时间(LOS)的因素进行了统计控制。参与者是参加HINH方案的老年护理机构居民(n=62)和接受常规住院护理的匹配组(n=115)。急诊科(ED)结果测量包括LOS和重现。结果：即使在调整了其他特征或0中心点16(95%CI 0中心点28，0中心点99p<；结论：HINH模型的评估重点是为老年护理机构居民提供急诊护理，可以影响卫生服务的提供。与临床实践相关。随着住院费用的减少，可用床位空间可用于其他在急诊室等待或等待手术的患者。
Aims and objectives.To undertake an outcomes evaluation of a Hospital in the Nursing Home (HINH) admission avoidance programme.Background.Admission avoidance type services such as Hospital in the Home have a place in improving service delivery for certain population groups. Research related to HINH has been limited, derived from various different health care systems internationally and results are varied.Design.A quasi-experimental study was conducted at one regional hospital. Routinely collected health information system data from two separate data sources were linked to undertake analysis.Methods.Those in the intervention group were matched to a comparison group of patients on the basis of three characteristics (age, gender and diagnostic category). Other factors that could affect a patient's hospital outcomes and length of stay (LOS) were statistically controlled for. Participants were aged care facility residents enrolled in a HINH programme (n = 62) and a matched group receiving usual in-hospital care (n = 115). Emergency department (ED) outcome measures included LOS and re-presentation. Hospital admission-related outcome measures included episode of care LOS, in-hospital LOS and hospital readmission.Results.A significant independent relationship between HINH programme enrolment and shorter in-hospital LOS was identified even after adjusting for other characteristics OR 0 center dot 16 (95% CI 0 center dot 28, 0 center dot 99 p < 0 center dot 001).Conclusion.The HINH model evaluated, with its focus on delivering acute care for aged care facility residents, can impact on health service delivery.Relevance to clinical practice.With a demonstrated reduction in in-hospital LOS, the available bed space created can be used for other patients perhaps waiting in the ED or waiting for surgery.