Impact of ‘Enhanced’ Intermediate Care Integrating Acute, Primary and Community Care and the Voluntary Sector in Torbay and South Devon, UK
dc.contributor.author | Elston, Julian | |
dc.contributor.author | Gradinger, Felix | |
dc.contributor.author | Asthana, Sheena | |
dc.contributor.author | Fox, M | |
dc.contributor.author | Dawson, L | |
dc.contributor.author | Butler, D | |
dc.contributor.author | Byng, Richard | |
dc.date.accessioned | 2022-02-14T16:24:13Z | |
dc.date.available | 2022-02-14T16:24:13Z | |
dc.date.issued | 2022-02-14 | |
dc.identifier.issn | 1568-4156 | |
dc.identifier.issn | 1568-4156 | |
dc.identifier.other | ARTN 14 | |
dc.identifier.uri | http://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.extent | 14- | |
dc.format.medium | Electronic-eCollection | |
dc.language | en | |
dc.language.iso | en | |
dc.publisher | Ubiquity Press, Ltd. | |
dc.subject | intermediate care | |
dc.subject | multi-disciplinary teams | |
dc.subject | person-centred care | |
dc.subject | voluntary sector | |
dc.subject | early supported discharge | |
dc.subject | admission avoidance | |
dc.title | Impact of ‘Enhanced’ Intermediate Care Integrating Acute, Primary and Community Care and the Voluntary Sector in Torbay and South Devon, UK | |
dc.type | journal-article | |
dc.type | Journal Article | |
plymouth.author-url | https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000795882600003&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=11bb513d99f797142bcfeffcc58ea008 | |
plymouth.issue | 1 | |
plymouth.volume | 22 | |
plymouth.publication-status | Published | |
plymouth.journal | International Journal of Integrated Care | |
dc.identifier.doi | 10.5334/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.place | England | |
dcterms.dateAccepted | 2022-01-28 | |
dc.rights.embargodate | 2022-2-16 | |
dc.identifier.eissn | 1568-4156 | |
dc.rights.embargoperiod | Not known | |
rioxxterms.versionofrecord | 10.5334/ijic.5665 | |
rioxxterms.licenseref.uri | http://www.rioxx.net/licenses/all-rights-reserved | |
rioxxterms.licenseref.startdate | 2022-02-14 | |
rioxxterms.type | Journal Article/Review |