Clinical effectiveness of an intermediate care inpatient model based on integrated care pathways
| Autor: | Miquel Àngel Mas, Ana Maria Alventosa, Joan Cunill, Manuela García-Lázaro, Francisco J Tarazona‐Santabalbina, Sebastià Santaeugènia, Albert Monterde, Alícia Gutiérrez-Benito |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Referral Clinical effectiveness Barthel index effectiveness Intervention group older people 03 medical and health sciences 0302 clinical medicine 030502 gerontology Acute care Humans Medicine Prospective Studies Aged integrated care Aged 80 and over Inpatients Delivery of Health Care Integrated business.industry Mean age Length of Stay Integrated care Hospitalization Treatment Outcome intermediate care care pathways Spain Physical therapy Intermediate Care Facilities 0305 other medical science business Intermediate care 030217 neurology & neurosurgery |
| Zdroj: | GERIATRICS & GERONTOLOGY INTERNATIONAL r-FISABIO: Repositorio Institucional de Producción Científica Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO) r-FISABIO. Repositorio Institucional de Producción Científica instname |
| ISSN: | 1447-0594 1444-1586 |
| Popis: | Aim The aim of this study was to compare the clinical impact of two intermediate care pathways. Methods A prospective, uncontrolled before-after study was carried out to compare two non-synchronic intermediate care frameworks in Spain. Participants in the control group were transferred to the intermediate care center by hospital request, whereas those in the intervention group (Badalona Integrated Care Model [BICM]) were transferred based on a territory approach considering the assessment of an intermediate care team. The clinical characteristics of study participants were assessed at admission and discharge. Results Compared with participants in the control group, those in the BICM group were significantly older (mean age 81.6 years [SD 10.3] vs 78.3 years [10.1], P < 0.001) and had a lower Barthel score (mean score 32.8 [SD 25.9] vs 39.9 [28.4]; P < 0.001), and a higher proportion of participants with total dependence (38.4% vs 32.2%; P = 0.001). The length of stay in intermediate care was similar in both groups; however, stay in acute care was significantly shorter in the BICM group than in the control group (mean 21 days [SD 19.5] vs 25 days [SD 23]; P < 0.001). No significant differences were found regarding the Barthel Index at discharge, although participants in the BICM group had significantly higher functional gain. Conclusions The implementation of a territory-based integrated care pathway in an intermediate care center shifted the profile of admitted patients toward higher complexity. Despite this, patients managed under the integrated care model reduced their dependency and the referral rate to an acute unit during their stay in the intermediate care center. Geriatr Gerontol Int 2020; center dot center dot: center dot center dot-center dot center dot. |
| Databáze: | OpenAIRE |
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