Community hospitals and older people.
Recent health care policy has promoted the community hospital as one remedy for the contracted district general hospital. Unfortunately, a literature review reveals a weak evidence-base to support this policy. Although descriptive studies demonstrate the flexible, multi-purpose role of community hospitals, there is a worrying paucity of clinical outcome studies and no robust health economic evaluation. An important potential role for community hospitals is in the post-acute care of older people. However, evaluation by randomized trial is required to demonstrate effectiveness and cost effectiveness of community hospital transfer compared to alternatives such as remaining in a district general hospital.
Young
J
J
Department of Elderly Care, St. Luke's Hospital, Bradford BD5 0NA, UK. john.young@bradfordhospitals.nhs.uk
Donaldson
K
K
D000368:Aged; D000369:Aged, 80 and over; D019317:Evidence-Based Medicine; D006291:Health Policy; D006764:Hospitals, Community / Q000458:organization & administration / Q000706:statistics & numerical data; D006767:Hospitals, District / Q000706:statistics & numerical data; D006801:Humans