Assessing the Impact of an Integrated Community Care Program on Unplanned Hospital and Emergency Department Representations: Interrupted Time Series Analysis.

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Tác giả: Nadine E Andrew, Kelly-Ann Bowles, Taya Collyer, Elise Deighton, Tanya Ravipati, Brendan Shannon, Cylie Williams

Ngôn ngữ: eng

Ký hiệu phân loại: 133.594 Types or schools of astrology originating in or associated with a

Thông tin xuất bản: England : Journal of advanced nursing , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 49674

BACKGROUND: This study aimed to evaluate the impact of the Community Care Program, which was the amalgamation of three outreach services-post-acute care, Residential In-Reach, and the Hospital Admission Risk Program-into a single integrated care model. Specifically, we assessed its effects on unplanned hospital readmissions and emergency department re-presentations at 30-, 60- and 90-days post-enrolment. METHODS: A pragmatic, real-world, population-based observational study was conducted using an interrupted time series analysis. The study included 4708 adult patients across two periods: pre-amalgamation (November 2014-October 2016), and post-amalgamation (May 2017-October 2018). Data were sourced from the National Centre for Healthy Ageing Data Platform, with statistical analyses conducted using Generalised Least Squares models to account for autocorrelation. RESULTS: The study observed a significant increase in quarterly program enrolments post-amalgamation, from 578 to 1011 per quarter. The 30-day readmission rate decreased from 11.8% to 8.52% post-amalgamation. However, interrupted time series analysis revealed no statistically significant changes in the slopes of readmission and emergency department re-presentation rates after the program's amalgamation. The program did not result in significant changes in 60- or 90-day outcomes. CONCLUSIONS: The amalgamation of post-acute care, Residential In-Reach, and the Hospital Admission Risk Program into the Community Care Program led to increased service utilisation without a significant impact on reducing unplanned hospital readmissions or emergency department re-presentations. Although the program amalgamation demonstrated improved accessibility, its longer-term impact remains inconclusive, highlighting the need for continuous refinement and further evaluation to optimise system efficiency. No patient or public contribution occurred in this study. REPORTING METHOD: This study adhered to the STROBE guidelines for observational research.
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