Intermediate care--a good thing?
In this paper, the intermediate care concept will be developed, and a new definition proposed. The evidence on effectiveness will be summarised, focusing on comprehensive geriatric assessment, admission avoidance, nurse-led units for post-acute care, and supported early discharge arrangements. It is a working premise of the paper that, in principle, intermediate care is not only a "good" but also a necessary "thing". However, with the exception of comprehensive assessment, the evidence for many services that fall under the broad rubric of intermediate care is lacking, inconclusive or negative. The implications of this for both practice and research will be discussed.
Steiner
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University of Southampton, Department of Geriatric Medicine, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK. steiner@cats.ucsc.edu
D000368:Aged; D000369:Aged, 80 and over; D019317:Evidence-Based Medicine; D005544:Forecasting; D016330:Frail Elderly; D015577:Geriatric Assessment; D006299:Health Services for the Aged / Q000458:organization & administration / Q000592:standards*; D006801:Humans; D007380:Intermediate Care Facilities / Q000458:organization & administration / Q000592:standards*; D011787:Quality of Health Care; D006113:United Kingdom