title: Improving hospital outcomes in patients admitted from residential aged care: results from a controlled trial.
abstract: BACKGROUND
  residents of aged care are old, frail and frequently require hospital management of intercurrent illness, but hospital outcomes are poor.
  
  
  OBJECTIVE
  to identify the impact of an interdisciplinary care model on medical inpatients admitted from residential aged care (RAC).
  
  
  METHODS
  pre-planned subgroup analysis of controlled trial.
  
  
  METHODS
  general medical units of a teaching hospital in Brisbane, Australia.
  
  
  METHODS
  consecutive patients aged over 65 admitted from RAC (n = 189) or the community (n = 815).
  
  
  METHODS
  all admitted general medical patients were allocated by existing cyclical roster to control (usual care) or intervention units (interdisciplinary care consisting of improved allied health staffing, consistent teams, daily team meetings and early discharge planning). Patient characteristics and outcomes of care were compared between RAC and community subgroups. In the RAC subgroup, outcomes were compared between the control and intervention groups.
  
  
  RESULTS
  patients admitted from RAC had much higher in-hospital mortality (13 versus 6%) and 6-month mortality (35 versus 17%) than those from community. RAC residents receiving the intervention had a significant reduction in in-hospital mortality (4 versus 22% P < 0.001) sustained at 6 months (28 versus 44% P = 0.02).
  
  
  CONCLUSIONS
  poor hospital outcomes for RAC residents may reflect prevailing models of inpatient care.
authors.affiliation: Internal Medicine and Aged Care, Royal Brisbane and Women's Hospital, 3rd Floor, James Mayne Building, Royal Brisbane and Women's Hospital, Herston, Brisbane, Queensland 4029, Australia. alison_mudge@health.qld.gov.au
authors.forename: Alison Mary
authors.initials: AM
authors.lastname: Mudge
authors.forename: Charles P
authors.initials: CP
authors.lastname: Denaro
authors.forename: Peter
authors.initials: P
authors.lastname: O'Rourke
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D005260:Female; D006707:Homes for the Aged / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team / Q000592:standards; D011446:Prospective Studies; D012111:Residence Characteristics / Q000706:statistics & numerical data*