Transitional Care Program in Reducing Acute Hospital Utilization in Singapore.

Publication date: Oct 28, 2024

(1) Background: The evidence to support transitional care in reducing acute hospital utilization is variable. Despite changes in the healthcare landscape with a rapidly aging population, there is a lack of local and regional studies to evaluate the effectiveness of transitional home care programs. This study investigates whether a transitional home care program delivered by an acute tertiary hospital can reduce acute hospital utilization. (2) Methods: A pre-post design was used to evaluate the effectiveness of the program. A total of 2004 enrolments from 1679 unique patients that fulfilled the criteria of enrolment were included. The transitional care program is delivered through telephone follow-up and home visits. The Wilcoxon Signed-Rank Test was used to assess the differences between the three periods of baseline, enrolment, and post-enrolment. (3) Results: All 2004 enrolments were analyzed. The re-attendances at the emergency department reduced significantly by 31. 2% and 71. 9% during enrolment and post-enrolment (p < 0. 001), respectively. Similarly, patients had a 38. 7% and 76. 2% reduction in hospital admissions during enrolment and post-enrolment (p < 0. 001), respectively. For patients who were admitted, there was no significant difference in the length of stay between these groups (p = 0. 23). (4) Conclusions: The transitional home care program can effectively reduce emergency department re-attendances and inpatient admissions. Not only was the total number of emergency department re-attendances reduced significantly, but the number of frequent re-attendances also dropped significantly. The outcomes were consistent during COVID-19 and post-pandemic phases. These findings can be used as a guide in program planning and future scalability.

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Concepts Keywords
Home care continuity
Inpatient health program
Pandemic home care
Singapore home visit
hospital admission
multimorbidity
transitional care

Semantics

Type Source Name
disease MESH emergency
disease MESH COVID-19
drug DRUGBANK Coenzyme M
disease IDO healthcare facility
disease IDO host
disease MESH chronic conditions
drug DRUGBANK Etoperidone
disease IDO process
disease MESH home environments
disease IDO intervention
disease IDO symptom
drug DRUGBANK Pentaerythritol tetranitrate
disease MESH frailty
disease MESH urinary tract infection
disease MESH pneumonia
disease MESH Chest pain
disease MESH Congestive heart failure
disease MESH Dyspnea
drug DRUGBANK Dextromethorphan
drug DRUGBANK Trestolone
drug DRUGBANK Methionine
disease MESH morbidities
drug DRUGBANK Guanosine
disease MESH multiple chronic conditions
disease MESH diabetes mellitus
disease IDO quality

Original Article

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