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Shifting care from community hospitals to intensive community support: a mixed method study.
- Source :
- Primary Health Care Research & Development; Jan2018, Vol. 19 Issue 1, p53-63, 11p
- Publication Year :
- 2018
-
Abstract
- AimTo examine how the introduction of intensive community support (ICS) affected admissions to community hospital (CH) and to explore the views of patients, carers and health professionals on this transition.BackgroundICS was introduced to provide an alternative to CH provision for patients (mostly very elderly) requiring general rehabilitation.MethodRoutine data from both services were analysed to identify the number of admissions and length of stay between September 2012 and September 2014. In total, 10 patients took part in qualitative interviews. Qualitative interviews and focus groups were undertaken with 19 staff members, including managers and clinicians.FindingsThere were 5653 admissions to CH and 1710 to ICS between September 2012 and September 2014. In the five months before the introduction of ICS, admission rates to CH were on average 217/month; in the final five months of the study, when both services were fully operational, average numbers of patients admitted were: CH 162 (a 25% reduction), ICS 97, total 259 (a 19% increase). Patients and carers rated both ICS and CH favourably compared with acute hospital care. Those who had experienced both services felt each to be appropriate at the time; they appreciated the 24 h availability of staff in CH when they were more dependent, and the convenience of being at home after they had improved. In general, staff welcomed the introduction of ICS and appreciated the advantages of home-based rehabilitation. Managers had a clearer vision of ICS than staff on the ground, some of whom felt underprepared to work in the community. There was a consensus that ICS was managing less complex and dependent patients than had been envisaged.ConclusionICS can provide a feasible adjunct to CH that is acceptable to patients. More work is needed to promote the vision of ICS amongst staff in both community and acute sectors. [ABSTRACT FROM PUBLISHER]
- Subjects :
- MEDICAL care
ELDER care
ATTITUDE (Psychology)
COMMUNITY health services
FOCUS groups
HOME care services
LENGTH of stay in hospitals
HOSPITALS
HOSPITAL admission & discharge
INTERVIEWING
RESEARCH methodology
MEDICAL personnel
NURSING care facilities
PATIENTS
REHABILITATION
RESEARCH funding
SUBACUTE care
DATA analysis software
PATIENTS' attitudes
DESCRIPTIVE statistics
Subjects
Details
- Language :
- English
- ISSN :
- 14634236
- Volume :
- 19
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- Primary Health Care Research & Development
- Publication Type :
- Academic Journal
- Accession number :
- 127178863
- Full Text :
- https://doi.org/10.1017/S1463423617000603