Abstract
ObjectiveTo assess effect of a complex, multidisciplinary intervention aimed at reducing avoidable acute hospitalization of residents of residential aged care (RAC) facilities. DesignCluster randomized controlled trial. SettingRAC facilities with higher than expected hospitalizations in Auckland, New Zealand, were recruited and randomized to intervention or control. ParticipantsA total of 1998 residents of 18 intervention facilities and 18 control facilities. InterventionA facility-based complex intervention of 9 months' duration. The intervention comprised gerontology nurse specialist (GNS)-led staff education, facility bench-marking, GNS resident review, and multidisciplinary (geriatrician, primary-care physician, pharmacist, GNS, and facility nurse) discussion of residents selected using standard criteria. Main outcome measuresPrimary end point was avoidable hospitalizations. Secondary end points were all acute admissions, mortality, and acute bed-days. Follow-up was for a total of 14 months. ResultsThe intervention did not affect main study end points: number of acute avoidable hospital admissions (RR 1.07; 95% CI 0.85–1.36; P = .59) or mortality (RR 1.11; 95% CI 0.76–1.61; P = .62). ConclusionsThis multidisciplinary intervention, packaging selected case review, and staff education had no overall impact on acute hospital admissions or mortality. This may have considerable implications for resourcing in the acute and RAC sectors in the face of population aging.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
More From: Journal of the American Medical Directors Association
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.