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Best place of care for older people after acute and during sub-acute illness: report of a national survey
- Authors:
- PARKER Gillian, et al
- Publisher:
- University of Leicester. Nuffield Community Care Studies Unit
- Publication year:
- 1999
- Pagination:
- 200p.
- Place of publication:
- Leicester
Acute hospital care is not necessarily the best way to look after all older people when they are ill. Their illnesses may not require the extensive range of services offered in an acute hospital and the admission and stay in an acute hospital, in itself, can be harmful for some frail people. The results of the systematic review of literature comparing alternative models of care with ‘conventional’ care for older people indicated that stroke units, early discharge schemes and in-patient rehabilitation delivered better outcomes at discharge in terms of mortality, physical function and discharge destination. However, it was unclear whether the improvements are maintained over the longer term or why they were achieved. The most significant finding was the lack of firm evidence about the quality, costs and effectiveness of different places of care. However, there is some evidence that admission avoidance schemes may have potential for reducing costs without worsening outcomes.
Position paper: intermediate care
- Authors:
- PARKER Gillian, PEET Susan
- Publisher:
- University of Leicester. Nuffield Community Care Studies Unit
- Publication year:
- 2001
- Pagination:
- 71p.
- Place of publication:
- Leicester
In the previous two decades there has been a greater impetus to manage patient flows within the National Health Service (NHS). Concerns about increasing number of older people in need of acute care combined with policy changes relating to community care which have the potential to slow down the process of discharging medically fit older people from hospital have resulted in a widening debate about the most appropriate means of providing acute health care to all patient groups. Recent policy initiatives, (including the National Performance Framework, the NHS Plan and, most recently, the National Service Framework for older people) provide clear commitments to providing appropriate, high quality and equitable services for older people. One of the significant features of these initiatives has been the growing importance of intermediate care as a vehicle for delivering health and social care to older people at the intersection of primary, acute and community care services. The announcement of substantial investment in intermediate care services for older people between now and 2004, underlines the need to know more both about how intermediate care services are being defined and used, and about the evidence that is available for best practice in this developing area.