How effective are programs at managing transition from hospital to home? A case study of the Australian transition care program

BMC Geriatrics

Debate

Leonard C Gray¹  Nancye M Peel¹  Maria Crotty²  Lynne C Giles³  Ian D Cameron⁴  Susan E Kurrle⁵ 

[1] Centre for Research in Geriatric Medicine, The University of Queensland, Level 2, Building 33, Princess Alexandra Hospital, 4102, Woolloongabba, Queensland, Australia;Department of Rehabilitation & Aged Care, Flinders University, Repatriation General Hospital, 5041, Daw Park, South Australia, Australia;Department of Rehabilitation & Aged Care, Flinders University, Repatriation General Hospital, 5041, Daw Park, South Australia, Australia;Discipline of Public Health, The University of Adelaide, 5005, South Australia, Australia;Rehabilitation Studies Unit, Sydney Medical School, University of Sydney, PO Box 6, 2112, Ryde, NSW, Australia;Rehabilitation and Aged Care Service, Hornsby Ku-ring-gai Hospital, 2077, Hornsby, NSW, Australia;

关键词: Residential Care;    Aged Care;    Care Recipient;    Residential Aged Care;    Residential Aged Care Facility;   

DOI  :  10.1186/1471-2318-12-6

 received in 2010-11-25, accepted in 2012-03-14,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundAn increasing demand for acute care services due in part to rising proportions of older people and increasing rates of chronic diseases has led to new models of post-acute care for older people that offer coordinated discharge, ongoing support and often a focus on functional restoration. Overall, review of the literature suggests there is considerable uncertainty around the effectiveness and resource implications of the various model configurations and delivery approaches. In this paper, we review the current evidence on the efficacy of such programs, using the Australian Transition Care Program as a case study.DiscussionThe Australian Transition Care Program was established at the interface of the acute and aged care sectors with particular emphasis on transitions between acute and community care. The program is intended to enable a significant proportion of care recipients to return home, rather than prematurely enter residential aged care, optimize their functional capacity, and reduce inappropriate extended lengths of hospital stay for older people. Broadly, the model is configured and targeted in accordance with programs reported in the international literature to be effective. Early evaluations suggest good acceptance of the program by hospitals, patients and staff. Ultimately, however, the program's place in the array of post-acute services should be determined by its demonstrated efficacy relative to other services which cater for similar patient groups.SummaryCurrently there is a lack of robust evaluation to provide convincing evidence of efficacy, either from a patient outcome or cost reduction perspective. As the program expands and matures, there will be opportunity to scrutinise the systematic effects, with lessons for both Australian and international policy makers and clinical leaders.

【 授权许可】

Unknown   
© Gray et al; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.