Hospital treatment in residential care facilities is a viable alternative to hospital admission for selected patients.
OBJECTIVE
To determine if hospital treatment in residential care facilities, led by a geriatric team, might be a viable alternative to inpatient admission for selected patients.


METHODS
Case series with a new intervention were compared with historical controls receiving the conventional treatment. Treatment in residential care facilities (TRC) by the Residential Care Intervention Program in The Elderly (RECIPE) service was compared against the conventional treatment group, aged care unit (ACU) inpatients.


RESULTS
A total of 95 patients in TRC and 167 patients in ACU were included. The mean Charlson Comorbidity Index score was 7 in both groups and demographics were similar, except more patients in the TRC group had dementia. Palliative care support was provided to 35.8% in the TRC group, compared with 7.8% in ACU, P < 0.001. Six-month mortality rates were similar at 30% for both groups. Rehospitalization rates at 6 months were similar at 41% for both groups. Length of care was significantly shorter for TRC (mean 2 days) compared with ACU (mean 11 days), P < 0.001.


CONCLUSIONS
Hospital treatment in residential care is viable for most patients, including those with dementia and those who need palliative care support. This model of care offers a valuable geriatric service to residents who would prefer to avoid hospital transfers, with no difference in mortality or rehospitalization rates for those treated in residential care, but a significant reduction in length of care.
Department of Aged Care, The Northern Clinical Research Centre, The University of Melbourne, Melbourne, Victoria, Australia.
Liza
L
Lau
Carol P
CP
Chong
Wen Kwang
WK
Lim
D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D003704:Dementia / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006299:Health Services for the Aged; D006757:Hospital Units; D006760:Hospitalization; D006784:Hospitals, Teaching; D006801:Humans; D007902:Length of Stay; D008297:Male; D010166:Palliative Care; D010343:Patient Admission; D010359:Patient Readmission; D010360:Patient Transfer; D010865:Pilot Projects; D012112:Residential Facilities; D012189:Retrospective Studies