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dc.contributor.authorElston, Julian
dc.contributor.authorGradinger, Felix
dc.contributor.authorAsthana, Sheena
dc.contributor.authorFox, M
dc.contributor.authorDawson, L
dc.contributor.authorButler, D
dc.contributor.authorByng, Richard
dc.date.accessioned2022-02-14T16:24:13Z
dc.date.available2022-02-14T16:24:13Z
dc.date.issued2022-02-14
dc.identifier.issn1568-4156
dc.identifier.issn1568-4156
dc.identifier.otherARTN 14
dc.identifier.urihttp://hdl.handle.net/10026.1/18773
dc.description.abstract

INTRODUCTION: Intermediate care (IC) was redesigned to manage more complex, older patients in the community, avoid admissions and facilitate earlier hospital discharge. The service was 'enhanced' by employing GPs, pharmacists and the voluntary sector to be part of a daily interdisciplinary team meeting, working alongside social workers and community staff (the traditional model). METHODS: A controlled before-and-after study, using mixed methods and a nested case study. Enhanced IC in one locality (Coastal) is compared with four other localities where IC was not enhanced until the following year (controls), using system-wide performance data (N = 4,048) together with ad hoc data collected on referral-type, staff inputs and patient experience (N = 72). RESULTS: Coastal showed statistically significant increase in EIC referrals to 11.6% (95%CI: 10.8%-12.4%), with a growing proportion from GPs (2.9%, 95%CI: 2.5%-3.3%); more people being cared for at home (10.5%, 95%CI: 9.8%-11.2%), shorter episode lengths (9.0 days, CI 95%: 7.6-10.4 days) and lower bed-day rates in ≥70 year-olds (0.17, 95%CI: 0.179-0.161). The nested case study showed medical, pharmacist and voluntary sector input into cases, a more holistic, coordinated service focused on patient priorities and reduced acute hospital admissions (5.5%). DISCUSSION AND CONCLUSION: Enhancing IC through greater acute, primary care and voluntary sector integration can lead to more complex, older patients being managed in the community, with modest impacts on service efficiency, system activity, and notional costs off-set by perceived benefits.

dc.format.extent14-
dc.format.mediumElectronic-eCollection
dc.languageen
dc.language.isoen
dc.publisherUbiquity Press, Ltd.
dc.subjectintermediate care
dc.subjectmulti-disciplinary teams
dc.subjectperson-centred care
dc.subjectvoluntary sector
dc.subjectearly supported discharge
dc.subjectadmission avoidance
dc.titleImpact of ‘Enhanced’ Intermediate Care Integrating Acute, Primary and Community Care and the Voluntary Sector in Torbay and South Devon, UK
dc.typejournal-article
dc.typeJournal Article
plymouth.author-urlhttps://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000795882600003&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=11bb513d99f797142bcfeffcc58ea008
plymouth.issue1
plymouth.volume22
plymouth.publication-statusPublished
plymouth.journalInternational Journal of Integrated Care
dc.identifier.doi10.5334/ijic.5665
plymouth.organisational-group/Plymouth
plymouth.organisational-group/Plymouth/Faculty of Health
plymouth.organisational-group/Plymouth/Faculty of Health/Peninsula Medical School
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA/UoA03 Allied Health Professions, Dentistry, Nursing and Pharmacy
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA/UoA20 Social Work and Social Policy
plymouth.organisational-group/Plymouth/Research Groups
plymouth.organisational-group/Plymouth/Research Groups/FoH - Community and Primary Care
plymouth.organisational-group/Plymouth/Research Groups/Institute of Health and Community
plymouth.organisational-group/Plymouth/Research Groups/Institute of Translational and Stratified Medicine (ITSMED)
plymouth.organisational-group/Plymouth/Research Groups/Institute of Translational and Stratified Medicine (ITSMED)/CCT&PS
plymouth.organisational-group/Plymouth/Research Groups/Plymouth Institute of Health and Care Research (PIHR)
plymouth.organisational-group/Plymouth/Users by role
plymouth.organisational-group/Plymouth/Users by role/Academics
dc.publisher.placeEngland
dcterms.dateAccepted2022-01-28
dc.rights.embargodate2022-2-16
dc.identifier.eissn1568-4156
dc.rights.embargoperiodNot known
rioxxterms.versionofrecord10.5334/ijic.5665
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2022-02-14
rioxxterms.typeJournal Article/Review


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