PDF(Pubmed)
Abstract：
UNASSIGNED: Intermediate care (IC) was redesigned to manage more complex, older patients in the community, avoid admissions and facilitate earlier hospital discharge. The service was \'enhanced\' by employing GPs, pharmacists and the voluntary sector to be part of a daily interdisciplinary team meeting, working alongside social workers and community staff (the traditional model).
UNASSIGNED: A controlled before-and-after study, using mixed methods and a nested case study. Enhanced IC in one locality (Coastal) is compared with four other localities where IC was not enhanced until the following year (controls), using system-wide performance data (N = 4,048) together with ad hoc data collected on referral-type, staff inputs and patient experience (N = 72).
UNASSIGNED: Coastal showed statistically significant increase in EIC referrals to 11.6% (95%CI: 10.8%-12.4%), with a growing proportion from GPs (2.9%, 95%CI: 2.5%-3.3%); more people being cared for at home (10.5%, 95%CI: 9.8%-11.2%), shorter episode lengths (9.0 days, CI 95%: 7.6-10.4 days) and lower bed-day rates in ≥70 year-olds (0.17, 95%CI: 0.179-0.161). The nested case study showed medical, pharmacist and voluntary sector input into cases, a more holistic, coordinated service focused on patient priorities and reduced acute hospital admissions (5.5%).
UNASSIGNED: Enhancing IC through greater acute, primary care and voluntary sector integration can lead to more complex, older patients being managed in the community, with modest impacts on service efficiency, system activity, and notional costs off-set by perceived benefits.
UNASSIGNED: A controlled before-and-after study, using mixed methods and a nested case study. Enhanced IC in one locality (Coastal) is compared with four other localities where IC was not enhanced until the following year (controls), using system-wide performance data (N = 4,048) together with ad hoc data collected on referral-type, staff inputs and patient experience (N = 72).
UNASSIGNED: Coastal showed statistically significant increase in EIC referrals to 11.6% (95%CI: 10.8%-12.4%), with a growing proportion from GPs (2.9%, 95%CI: 2.5%-3.3%); more people being cared for at home (10.5%, 95%CI: 9.8%-11.2%), shorter episode lengths (9.0 days, CI 95%: 7.6-10.4 days) and lower bed-day rates in ≥70 year-olds (0.17, 95%CI: 0.179-0.161). The nested case study showed medical, pharmacist and voluntary sector input into cases, a more holistic, coordinated service focused on patient priorities and reduced acute hospital admissions (5.5%).
UNASSIGNED: Enhancing IC through greater acute, primary care and voluntary sector integration can lead to more complex, older patients being managed in the community, with modest impacts on service efficiency, system activity, and notional costs off-set by perceived benefits.
摘要：
未经评估：重新设计了中级护理（IC），以管理更复杂的，社区中的老年患者，避免入院并促进提早出院。该服务通过使用GP进行了“增强”，药剂师和志愿部门将成为每日跨学科团队会议的一部分，与社会工作者和社区工作人员一起工作(传统模式)。
未经评估：一项前后对照研究，使用混合方法和嵌套案例研究。将一个地区（沿海）的增强IC与其他四个地区进行比较，这些地区直到第二年才增强IC（对照），使用全系统性能数据(N=4,048)以及在推荐类型上收集的临时数据，工作人员输入和患者体验(N=72)。
UNASSIGNED：沿海显示EIC转诊的统计学显着增加至11.6％（95CI：10.8％-12.4％），全科医生的比例越来越高(2.9%，95CI：2.5%-3.3%）；更多的人在家里得到照顾（10.5%，95CI：9.8%-11.2%），较短的发作长度(9.0天，CI95%：7.6-10.4天），≥70岁人群的床-日率较低（0.17，95CI：0.179-0.161）。嵌套案例研究显示，药剂师和志愿部门对案件的投入，更全面的，协调服务侧重于患者优先事项，减少急性住院(5.5%)。
未经授权：通过更大的急性增强IC，初级保健和志愿部门的整合可能会导致更复杂的，老年患者在社区管理，对服务效率的影响不大，系统活动,和名义成本被感知到的利益抵消。
未经评估：一项前后对照研究，使用混合方法和嵌套案例研究。将一个地区（沿海）的增强IC与其他四个地区进行比较，这些地区直到第二年才增强IC（对照），使用全系统性能数据(N=4,048)以及在推荐类型上收集的临时数据，工作人员输入和患者体验(N=72)。
UNASSIGNED：沿海显示EIC转诊的统计学显着增加至11.6％（95CI：10.8％-12.4％），全科医生的比例越来越高(2.9%，95CI：2.5%-3.3%）；更多的人在家里得到照顾（10.5%，95CI：9.8%-11.2%），较短的发作长度(9.0天，CI95%：7.6-10.4天），≥70岁人群的床-日率较低（0.17，95CI：0.179-0.161）。嵌套案例研究显示，药剂师和志愿部门对案件的投入，更全面的，协调服务侧重于患者优先事项，减少急性住院(5.5%)。
未经授权：通过更大的急性增强IC，初级保健和志愿部门的整合可能会导致更复杂的，老年患者在社区管理，对服务效率的影响不大，系统活动,和名义成本被感知到的利益抵消。
