An intervention program to reduce the number of hospitalizations of elderly patients in a primary care clinic.
BACKGROUND
The elderly population consumes a large share of medical resources in the western world. A significant portion of the expense is related to hospitalizations.


OBJECTIVE
To evaluate an intervention program designed to reduce the number of hospitalization of elderly patients by a more optimal allocation of resources in primary care.


METHODS
A multidimensional intervention program was conducted that included the re-engineering of existing work processes with a focus on the management of patient problems, improving communication with outside agencies, and the establishment of a system to monitor quality of healthcare parameters. Data on the number of hospitalizations and their cost were compared before and after implementation of the intervention program.


RESULTS
As a result of the intervention the mean expenditure per elderly patient was reduced by 22.5%. The adjusted number of hospitalizations/1,000 declined from 15.1 to 10.7 (29.3%). The number of adjusted hospitalization days dropped from 132 to 82 (37.9%) and the mean hospitalization stay declined from 8.2 to 6.7 days (17.9%). The adjusted hospitalization cost ($/1,000 patients) dropped from $32,574 to $18,624 (42.8%). The overall clinic expense, for all age groups, dropped by 9.9%.


CONCLUSIONS
Implementation of the intervention program in a single primary care clinic led to a reduction in hospitalizations for the elderly patient population and to a more optimal allocation of healthcare resources.
Peleg
Roni
R
Clalit Health Services, Southern District, Israel. pelegr@bgumail.bgu.ac.il
Press
Yan
Y
Asher
Maya
M
Pugachev
Tatyana
T
Glicensztain
Hadas
H
Lederman
Mila
M
Biderman
Aya
A
D000368:Aged; D000369:Aged, 80 and over; D003151:Community Health Centers / Q000458:organization & administration / Q000592:standards*; D005853:Geriatrics / Q000458:organization & administration / Q000592:standards*; D006299:Health Services for the Aged / Q000458:organization & administration / Q000592:standards*; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data*; D006801:Humans; D033183:Interdisciplinary Communication; D007557:Israel; D009313:National Health Programs; D010348:Patient Care Team; D018802:Patient-Centered Care / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration / Q000592:standards*; D015397:Program Evaluation; D019984:Quality Indicators, Health Care; D012017:Referral and Consultation; D040841:Resource Allocation