Search results for ‘Subject term:"intermediate care"’ Sort:
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A national evaluation of the costs and outcomes of intermediate care for older people
- Authors:
- BARTON Pelham, et al
- Publisher:
- University of Leicester. Leicester Nuffield Research Unit
- Publication year:
- 2006
- Pagination:
- 167p., bibliog.
- Place of publication:
- Leicester
A national evaluation of the costs and outcomes of intermediate care for older people. Intermediate care is a key government priority, with £900 million announced in the NHS Plan. This three year evaluation from the Universities of Birmingham, Leicester and Sheffield focuses on the factors that help and hinder the development of intermediate care, on progress to date, and on the costs and outcomes associated with different types of intermediate care. The evaluation, which was funded from the Policy Research Programme and the MRC, seeks to establish the range, spread and speed of development of intermediate care services nationally, and to explore commissioners’, practitioners’ and service users’ views and experiences of intermediate care. HSMC’s contribution to the evaluation has centred upon two main areas: Colleagues within the Health Economics Facility (HEF) have explored the costs of intermediate care schemes in relation to their outcomes and synthesised evidence on the costs and outcomes of different models of intermediate care and on best practice; HSMC colleagues have carried out research in several case-study sites in order to explore the development of intermediate care in depth, including those factors which facilitate and constrain progress.
The road to recovery: a feasibility study into homeless intermediate care
- Author:
- LANE Robyn
- Publisher:
- Great Britain. Department of Health. Health and Social Care Change Agent Team
- Publication year:
- 2005
- Pagination:
- 66p.
- Place of publication:
- London
Report on the need for improved hospital discharge procedures for homeless people. Highlights the need for more suitable recovery facilities and better provision for people with complex needs.
Transitional care facility for elderly people in hospital awaiting a long term care bed: randomised controlled trial
- Authors:
- CROTTY Maria, et al
- Journal article citation:
- British Medical Journal, 12.11.05, 2005, pp.1110-1113.
- Publisher:
- British Medical Association
This Australian study aimed to assess the effectiveness of moving patients who are waiting in hospital for a long term care bed to an off-site transitional care facility. The participants were 320 elderly patients in acute hospital beds (212 randomised to intervention, 108 to control). The intervention used was a transitional care facility where all patients received a single assessment from a specialist elder care team and appropriate ongoing therapy. The main outcome measures used included the length of stay in hospital, rates of readmission, deaths, and patient's functional level (modified Barthel index), quality of life (assessment of quality of life), and care needs (residential care scale) at four months. From admission, those in the intervention group stayed a median of 32.5 days in hospital. In the control group the median length of stay was 43.5 days. Patients in the intervention group took a median of 21 days longer to be admitted to permanent care than those in the control group. In both groups few patients went home (14 (7%) in the intervention group v 9 (9%) in the control group). There were no significant differences in death rates (28% v 27%) or rates of transfer back to hospital (28% v 25%). The authors conclude that for frail elderly patients who are awaiting a residential care bed transfer out of hospital to an off-site transitional care unit with focus on aged care "unblocks beds" without adverse effects.
Profiling intermediate care patients using the single assessment process: a road to better service provision?
- Authors:
- MACKENZIE Mathew, CARPENTER Iain, KOTIADIS Kathy
- Journal article citation:
- Journal of Integrated Care, 13(4), August 2005, pp.43-48.
- Publisher:
- Emerald
This paper demonstrates that three intermediate care services in Shepway, East Kent each cater for distinct patient groups, and that data from a single assessment process (SAP) tool can be used to differentiate between them. By applying statistical techniques, inferences can be made about the likelihood of admission to a particular service, given specific health characteristics. In conclusion, we highlight the utility of standardised assessment as a means of providing data for audit and planning, and stress the importance of the SAP as a means of developing care services.
A prospective baseline study of frail older people before the introduction of an immediate care service
- Authors:
- YOUNG John, et al
- Journal article citation:
- Health and Social Care in the Community, 13(4), July 2005, pp.307-312.
- Publisher:
- Wiley
This article describes the first part of a two-stage research project designed to investigate the clinical and service outcomes of a comprehensive intermediate care service. It is a baseline study of patients presenting to two elderly care departments as emergencies with the clinical syndromes of falls, incontinence, confusion or poor mobility before the introduction of a city-wide intermediate care service. The outcome measures were: mortality; disability (Barthel Index, BI); social activities (Nottingham Extended Activities of Daily Living); service use; and carer distress (General Health Questionnaire 28). These were measured at 3, 6 and 12 months after recruitment. Eight hundred and twenty-three patients were recruited (median age 84 years; 70% were women; 45% had cognitive impairment). There was a high mortality rate (36%), evidence for incomplete recovery, a gradual decline in independence over 12 months and a high degree of carer stress. There was little use of rehabilitation services, about 25% required readmission to hospital by each assessment point and there was a gradual increase in institutional care admissions. These findings support a needs-based argument for a more comprehensive community service for frail older people.
Intermediate care: older people's involvement and experiences
- Authors:
- MANTHORPE Jill, CORNES Michelle
- Journal article citation:
- Journal of Integrated Care, 12(6), December 2004, pp.43-48.
- Publisher:
- Emerald
New service models such as intermediate care may find it difficult to involve older people in services that are time-limited and unfamiliar. Their staff may perceive themselves as having little time to sustain or build relationships with voluntary and community-based organisations engaged in intermediate care. This article shows how such challenges can be met by drawing on the experiences of voluntary sector projects involved in intermediate care services. The article focuses on practitioners' experiences of involving older people in intermediate care assessment and treatment and, secondly on the views of older people about the information they received.
Diversity in intermediate care
- Authors:
- MARTIN Graham Paul, et al
- Journal article citation:
- Health and Social Care in the Community, 12(2), March 2004, pp.150-154.
- Publisher:
- Wiley
Discusses the evolution of intermediate care (IC) and presents interim observations from a survey of providers in England being conducted as part of a national evaluation. Telephone interviews covering various issues concerning level of provision and style of delivery have been conducted with 70 services. Data are used to discuss the progress, range and nature of IC in relation to clinician viewpoints and academic and official literature on the subject. IC 'on the ground' is a multiplicitous entity, with provision apparently evolving in accordance with the particularities of local need. While protocols for medical involvement in IC generally appear to be well established, there are some tensions concerning integration of services in a locality, care management processes and questions of flexibility and inclusiveness in relation to eligibility criteria.
Intermediate care: from innovation to post-mortem?
- Author:
- WILSON Keith
- Journal article citation:
- Journal of Integrated Care, 11(6), December 2003, pp.4-6.
- Publisher:
- Emerald
Presents a critical overview of the creation and implementation of the national policy for intermediate care.
An estimate of post-acute intermediate care need in an elderly care department for older people
- Authors:
- YOUNG John, FORSTER Anne, GREEN John
- Journal article citation:
- Health and Social Care in the Community, 11(3), May 2003, pp.229-231.
- Publisher:
- Wiley
There is an expectation that intermediate care services for older people will be widely introduced in England. Their planning should be based on an understanding of required capacity. This study provides a needs estimate for post-acute intermediate care. Older patients admitted acutely to an elderly care department in a district general hospital serving a large city in northern England were followed prospectively by a research team until medical stability had occurred in the opinion of the senior ward nurses and the responsible consultant. Clinical staff then determined if the patient had continuing post-acute care needs or if imminent discharge was possible. Of 1,211 acutely admitted patients, 997 became medically stable and 312 (25.8% of admissions) were considered to require post-acute care, and of these, 251 (20.7% of admissions) needed post-acute rehabilitation care. Suggests that such services should have capacity to address the needs of up to one-quarter of acute admissions to a district general hospital elderly care department.
Guest editorial: intermediate care and general practitioners: an uncertain relationship
- Authors:
- WILSON A., PARKER H.
- Journal article citation:
- Health and Social Care in the Community, 11(2), March 2003, pp.81-84.
- Publisher:
- Wiley
Discusses attempts to provide community-based alternatives to acute hospital admission, dubbed intermediate care by the Department of Health in 2000. Explores the literature on general practitioners' attitudes to such schemes, their involvement in referring to and participating in them, and the workload implications in terms of quantity and quality. Their representative bodies' attitude seems one of guarded support. Concludes GPs' provision of medical care to intermediate care schemes is at risk of becoming their weakest link.