title: Hospital in the Nursing Home program reduces emergency department presentations and hospital admissions from residential aged care facilities in Queensland, Australia: a quasi-experimental study.
abstract: BACKGROUND
  There has been considerable publicity regarding population ageing and hospital emergency department (ED) overcrowding. Our study aims to investigate impact of one intervention piloted in Queensland Australia, the Hospital in the Nursing Home (HiNH) program, on reducing ED and hospital attendances from residential aged care facilities (RACFs).
  
  
  METHODS
  A quasi-experimental study was conducted at an intervention hospital undertaking the program and a control hospital with normal practice. Routine Queensland health information system data were extracted for analysis.
  
  
  RESULTS
  Significant reductions in the number of ED presentations per 1000 RACF beds (rate ratio (95 % CI): 0.78 (0.67-0.92); p = 0.002), number of hospital admissions per 1000 RACF beds (0.62 (0.50-0.76); p < 0.0001), and number of hospital admissions per 100 ED presentations (0.61 (0.43-0.85); p = 0.004) were noticed in the experimental hospital after the intervention; while there were no significant differences between intervention and control hospitals before the intervention. Pre-test and post-test comparison in the intervention hospital also presented significant decreases in ED presentation rate (0.75 (0.65-0.86); p < 0.0001) and hospital admission rate per RACF bed (0.66 (0.54-0.79); p < 0.0001), and a non-significant reduction in hospital admission rate per ED presentation (0.82 (0.61-1.11); p = 0.196).
  
  
  CONCLUSIONS
  Hospital in the Nursing Home program could be effective in reducing ED presentations and hospital admissions from RACF residents. Implementation of the program across a variety of settings is preferred to fully assess the ongoing benefits for patients and any possible cost-savings.
authors: School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane, QLD, 4059, Australia. keirafanlj@gmail.com.
authors: Lijun
authors: L
authors: Fan
authors: School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane, QLD, 4059, Australia. x.hou@qut.edu.au.
authors: Xiang-Yu
authors: XY
authors: Hou
authors: Bureau of Investment Promotion, Wuwei City, 733000, Gansu Province, P. R. China. jimzhao1985@163.com.
authors: Jingzhou
authors: J
authors: Zhao
authors: Queensland Health, Brisbane, QLD, 4029, Australia. j1.sun@qut.edu.au.
authors: Jiandong
authors: J
authors: Sun
authors: School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane, QLD, 4059, Australia. k.dingle@qut.edu.au.
authors: Kaeleen
authors: K
authors: Dingle
authors: Department of Emergency Medicine, Royal Brisbane and Women's Hospital, Brisbane, QLD, 4006, Australia. Rhonda.Purtill2@health.qld.gov.au.
authors: Rhonda
authors: R
authors: Purtill
authors: Department of Emergency Medicine, Royal Brisbane and Women's Hospital, Brisbane, QLD, 4006, Australia. Sam.Tapp@health.qld.gov.au.
authors: Sam
authors: S
authors: Tapp
authors: Department of Emergency Medicine, Royal Brisbane and Women's Hospital, Brisbane, QLD, 4006, Australia. Bill.Lukin@health.qld.gov.au.
authors: Bill
authors: B
authors: Lukin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D040561:Assisted Living Facilities; D001315:Australia; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D015397:Program Evaluation; D011793:Queensland; D013223:Statistics as Topic