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Shifting care from community hospitals to intensive community support: a mixed method study.

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journal contribution
posted on 03.11.2017, 14:58 by Kate S. Williams, Stoyan Kurtev, Kay Phelps, Emma Regen, Simon Conroy, Andrew Wilson
Aim To examine how the introduction of intensive community support (ICS) affected admissions to community hospital (CH) and to explore the views of patients, carers and health professionals on this transition. BACKGROUND: ICS was introduced to provide an alternative to CH provision for patients (mostly very elderly) requiring general rehabilitation. METHOD: Routine data from both services were analysed to identify the number of admissions and length of stay between September 2012 and September 2014. In total, 10 patients took part in qualitative interviews. Qualitative interviews and focus groups were undertaken with 19 staff members, including managers and clinicians. Findings There were 5653 admissions to CH and 1710 to ICS between September 2012 and September 2014. In the five months before the introduction of ICS, admission rates to CH were on average 217/month; in the final five months of the study, when both services were fully operational, average numbers of patients admitted were: CH 162 (a 25% reduction), ICS 97, total 259 (a 19% increase). Patients and carers rated both ICS and CH favourably compared with acute hospital care. Those who had experienced both services felt each to be appropriate at the time; they appreciated the 24 h availability of staff in CH when they were more dependent, and the convenience of being at home after they had improved. In general, staff welcomed the introduction of ICS and appreciated the advantages of home-based rehabilitation. Managers had a clearer vision of ICS than staff on the ground, some of whom felt underprepared to work in the community. There was a consensus that ICS was managing less complex and dependent patients than had been envisaged. CONCLUSION: ICS can provide a feasible adjunct to CH that is acceptable to patients. More work is needed to promote the vision of ICS amongst staff in both community and acute sectors.

Funding

The study was funded by the Community Trust.

History

Citation

Primary Health Care Research and Development, 2017, pp. 1-11

Author affiliation

/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine/Department of Health Sciences

Version

AM (Accepted Manuscript)

Published in

Primary Health Care Research and Development

Publisher

Cambridge University Press (CUP)

issn

1463-4236

eissn

1477-1128

Acceptance date

17/08/2017

Copyright date

2017

Available date

13/03/2018

Publisher version

https://www.cambridge.org/core/journals/primary-health-care-research-and-development/article/shifting-care-from-community-hospitals-to-intensive-community-support-a-mixed-method-study/A1E2A114CD9AC1CC30E6949C7469CC31

Notes

The file associated with this record is under embargo until 6 months after publication, in accordance with the publisher's self-archiving policy. The full text may be available through the publisher links provided above.

Language

en