Health service utilisation and health outcomes of residential aged care residents referred to a hospital avoidance program: A multi-site retrospective quasi-experimental study.

OBJECTIVE: To compare the health system utilisation patterns and health outcomes of residential aged care facility (RACF) residents reviewed by a hospital avoidance program to those of RACF residents who received usual care. METHODS: A retrospective evaluation of a hospital avoidance program provided by a hospital-based medical and nursing outreach team. Residents reviewed by the program were randomly matched 1:1 to comparison group residents based on age group, sex and number of co-morbidities. Number of hospital admissions, excess hospital length of stay and excess hospital treatment costs were compared. RESULTS: Residents reviewed by the program spent an average 9-10 days fewer in hospital with AUD$2,091 to $8,014 lower hospital treatment costs compared to comparison group residents. CONCLUSION: Rapid provision of outreach services for the management of acute care of RACF residents may reduce the number of days residents spend in hospital, as well as reducing the associated hospital treatment costs.

Comparison of health service use trajectories of residential aged care residents reviewed by a hospital avoidance program versus usual care.

OBJECTIVE: To compare health service use trajectories of residential aged care facility (RACF) residents reviewed by the Aged Care Rapid Response Team (ARRT) to RACF residents who received usual care. METHODS: A retrospective group-based trajectory analysis of RACF residents aged ≥65 years who were reviewed by ARRT during 1 July 2015 to 30 June 2016 was conducted. Health service use trajectories were followed for two years to 30 June 2018 and compared to RACF residents aged ≥65 years who lived in the same Local Health District and received usual care. RESULTS: There were 2,245 ARRT-reviewed resident hospitalisations and 11,892 usual care resident hospital admissions during 2015-16. Trajectory analysis categorised ARRT-reviewed residents into four groups and usual care residents into three groups. Age, comorbid health conditions and dementia were predictors of group membership in both ARRT-reviewed RACF residents and usual care RACF residents. Additionally, gender predicted group membership in ARRT-reviewed RACF residents and fall-related injuries predicted group membership in usual care RACF residents. CONCLUSION: The identification of health service use trajectories assists in understanding hospital use by older RACF residents and may offer guidance in the design of prevention measures, including hospital avoidance programs.