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Effectiveness of an intermediate care hospital on readmissions, mortality, activities of daily living and use of health care services among hospitalized adults aged 60 years and older; a controlled observational study

Dahl, Unni Alice; Steinsbekk, Aslak; Johnsen, Roar
Journal article, Peer reviewed
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URI
http://hdl.handle.net/11250/300447
Date
2015
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  • Institutt for samfunnsmedisin og sykepleie [1766]
  • Publikasjoner fra CRIStin - NTNU [20940]
Original version
BMC Health Services Research 2015, 15(351)   10.1186/s12913-015-1022-x
Abstract
Background: Intermediate care is a health care model developed to optimize the coordination of health care

services and functional independence. In Central Norway, an intermediate care hospital (ICH) was established in a

municipality to improve hospital discharge and follow-up among elderly patients with chronic conditions and

comprehensive care needs. The aim of this study was to investigate the effectiveness of hospital discharges to a

municipality with an ICH compared to discharges to a municipality without an ICH.

Methods: This was a non-randomized controlled observational study of hospitalized patients aged 60 years and

older from two municipalities. Patients (n = 328) admitted to a general hospital from February 2010 through

September 2011 were included in the study and followed for 12 months. The data were analyzed using descriptive

statistics, analysis of covariance (ANCOVA) and Cox proportional hazard regression.

Results: Each patient discharged from the general hospital to the municipality with an ICH had a shorter length of

stay and used on average 4.2 (p = 0.046) fewer hospital days during 1 year compared to patients from the

municipality without an ICH. Otherwise, no statistical significant differences were found between the municipalities

in terms of hospital readmissions, admissions, mortality, activities of daily living, primary health care utilization or

total care days. A post hoc analysis of patients discharged to the ICH compared to the municipality without an ICH,

showed that the ICH patients were older and frailer, but the outcome was similar to the main analysis.

Conclusions: Having an ICH in the municipality facilitated shorter length of hospital stay and kept the risk of

readmissions, mortality and post-hospitalization care needs at the same level as without an ICH.
Publisher
BioMed Central
Journal
BMC Health Services Research

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