Hospital in the Nursing Home program reduces emergency department presentations and hospital admissions from residential aged care facilities in Queensland, Australia: a quasi-experimental study

Article

Fan, Lijun, Hou, Xiang-Yu, Zhao, Jingzhou, Sun, Jiandong, Dingle, Kaeleen, Purtill, Rhonda, Tapp, Sam and Lukin, Bill. 2016. "Hospital in the Nursing Home program reduces emergency department presentations and hospital admissions from residential aged care facilities in Queensland, Australia: a quasi-experimental study." BMC Health Services Research. 16, pp. 1-9. https://doi.org/10.1186/s12913-016-1275-z
Article Title

Hospital in the Nursing Home program reduces emergency department presentations and hospital admissions from residential aged care facilities in Queensland, Australia: a quasi-experimental study

ERA Journal ID13444
Article CategoryArticle
AuthorsFan, Lijun (Author), Hou, Xiang-Yu (Author), Zhao, Jingzhou (Author), Sun, Jiandong (Author), Dingle, Kaeleen (Author), Purtill, Rhonda (Author), Tapp, Sam (Author) and Lukin, Bill (Author)
Journal TitleBMC Health Services Research
Journal Citation16, pp. 1-9
Article Number46
Number of Pages9
Year2016
PublisherBioMed Central Ltd.
Place of PublicationUnited Kingdom
ISSN1472-6963
Digital Object Identifier (DOI)https://doi.org/10.1186/s12913-016-1275-z
Web Address (URL)https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-016-1275-z
Abstract

Background
There has been considerable publicity regarding population ageing and hospital emergency department (ED) overcrowding. Our study aims to investigate impact of one intervention piloted in Queensland Australia, the Hospital in the Nursing Home (HiNH) program, on reducing ED and hospital attendances from residential aged care facilities (RACFs).

Methods
A quasi-experimental study was conducted at an intervention hospital undertaking the program and a control hospital with normal practice. Routine Queensland health information system data were extracted for analysis.

Results
Significant reductions in the number of ED presentations per 1000 RACF beds (rate ratio (95 % CI): 0.78 (0.67–0.92); p = 0.002), number of hospital admissions per 1000 RACF beds (0.62 (0.50–0.76); p < 0.0001), and number of hospital admissions per 100 ED presentations (0.61 (0.43–0.85); p = 0.004) were noticed in the experimental hospital after the intervention; while there were no significant differences between intervention and control hospitals before the intervention. Pre-test and post-test comparison in the intervention hospital also presented significant decreases in ED presentation rate (0.75 (0.65–0.86); p < 0.0001) and hospital admission rate per RACF bed (0.66 (0.54–0.79); p < 0.0001), and a non-significant reduction in hospital admission rate per ED presentation (0.82 (0.61–1.11); p = 0.196).

Conclusions
Hospital in the Nursing Home program could be effective in reducing ED presentations and hospital admissions from RACF residents. Implementation of the program across a variety of settings is preferred to fully assess the ongoing benefits for patients and any possible cost-savings.

KeywordsEmergency Department; Health Services for the aged; Hospital in Nursing Home; public hospital
ANZSRC Field of Research 2020420311. Health systems
420306. Health care administration
420305. Health and community services
Byline AffiliationsQueensland University of Technology
China Investment Promotion Agency, China
Department of Health, Queensland
Institution of OriginUniversity of Southern Queensland
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