title: Effectiveness of an intermediate care hospital on readmissions, mortality, activities of daily living and use of health care services among hospitalized adults aged 60 years and older--a controlled observational study.
abstract: BACKGROUND
  Intermediate care is a health care model developed to optimize the coordination of health care services and functional independence. In Central Norway, an intermediate care hospital (ICH) was established in a municipality to improve hospital discharge and follow-up among elderly patients with chronic conditions and comprehensive care needs. The aim of this study was to investigate the effectiveness of hospital discharges to a municipality with an ICH compared to discharges to a municipality without an ICH.
  
  
  METHODS
  This was a non-randomized controlled observational study of hospitalized patients aged 60 years and older from two municipalities. Patients (n = 328) admitted to a general hospital from February 2010 through September 2011 were included in the study and followed for 12 months. The data were analyzed using descriptive statistics, analysis of covariance (ANCOVA) and Cox proportional hazard regression.
  
  
  RESULTS
  Each patient discharged from the general hospital to the municipality with an ICH had a shorter length of stay and used on average 4.2 (p = 0.046) fewer hospital days during 1 year compared to patients from the municipality without an ICH. Otherwise, no statistical significant differences were found between the municipalities in terms of hospital readmissions, admissions, mortality, activities of daily living, primary health care utilization or total care days. A post hoc analysis of patients discharged to the ICH compared to the municipality without an ICH, showed that the ICH patients were older and frailer, but the outcome was similar to the main analysis.
  
  
  CONCLUSIONS
  Having an ICH in the municipality facilitated shorter length of hospital stay and kept the risk of readmissions, mortality and post-hospitalization care needs at the same level as without an ICH.
authors: Department of Public Health and General Practice, Norwegian University of Science and Technology, Post box 8905 Medisinsk teknisk forskningssenter, 7491, Trondheim, Norway. unni.dahl@ntnu.no.|Central Norway Health Authority, 7500, Stjørdal, Norway. unni.dahl@ntnu.no.
authors: Unni
authors: U
authors: Dahl
authors: Department of Public Health and General Practice, Norwegian University of Science and Technology, Post box 8905 Medisinsk teknisk forskningssenter, 7491, Trondheim, Norway. aslak.steinsbekk@ntnu.no.
authors: Aslak
authors: A
authors: Steinsbekk
authors: Department of Public Health and General Practice, Norwegian University of Science and Technology, Post box 8905 Medisinsk teknisk forskningssenter, 7491, Trondheim, Norway. roar.johnsen@ntnu.no.
authors: Roar
authors: R
authors: Johnsen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000203:Activities of Daily Living; D006760:Hospitalization / Q000706:statistics & numerical data; D006769:Hospitals, General; D007380:Intermediate Care Facilities; D007902:Length of Stay; D009026:Mortality / Q000639:trends; D009664:Norway / Q000453:epidemiology; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data