Keeping residential aged care facility residents out of hospital

Photo credit: camilo jimenez / Unsplash

As people age, they are more likely to require additional health services, including emergency care or hospitalisation. For frail older adults living in residential aged care facilities (RACFs), transfer to hospital can increase the risk of harms, such as future care complications and medication errors, in addition to the potential for hospital acquired complications.

To reduce avoidable hospitalisations and emergency department visits, several health systems have trialed innovative outreach programs. One aim of these programs is to provide treatment to RACF residents at the facility, rather in a hospital setting, whenever possible. However, it is largely unknown whether these programs change the rate of hospitalisation or if they have any impact on health outcomes compared to the usual models of care.

In their recent article, Health service utilisation and health outcomes of residential aged care residents referred to a hospital avoidance program: A multi‐site retrospective quasi‐experimental study, published by The Australasian Journal on Ageing, PCHSS chief investigator Jeffrey Braithwaite and colleagues explored the impact of a novel hospital avoidance program on hospital use patterns of RACF residents in NSW, Australia. The model of care evaluated by the team involved an aged care rapid response team which provided consultations and treatments to residents in aged care facilities.

Fewer days in hospital and cost savings for the system

Overall, the results of the study were promising. Compared with RACF residents who were not part of the program, residents reviewed by the hospital avoidance program team spent an average of 9-10 days fewer in hospital (leading to hospital care cost savings of between $2,091 and $8,014 per resident). The results also suggest some potential positive effects on residents’ health outcomes.

This research has important implications for how health systems manage the interface between RACF residents and hospital services.

As the authors explain:

“The current study adds to an emerging body of evidence supporting the provision of outreach services to residential aged care facilities by a hospital‐based team. This represents a novel reorganisation of services to bridge the care gap between aged care and acute care services.”

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