Abstract
Abstract
Background:
Growth in emergency department (ED) attendance and acute medical admissions has been managed to very low rates for 18 years in Canterbury, New Zealand, using a combination of community and hospital avoidance strategies. This paper describes the specific strategies that supported management of acutely unwell patients in the community as part of a programme to integrate health services.
Intervention:
Community-based acute care was established by a culture of close collaboration and trust between all sectors of the health system, with general practice closely involved in the design and management of the services, and support provided by hospital specialists, coordination and diagnostic units, and competent informatics. Introduction of the community-based services was aided by a clinical guidance website and an education programme for general practice teams and allied health professionals.
Outcomes:
Attendance at EDs and acute medical admission rates have been held at low growth and, in some cases, shorter lengths of hospital stay. This trend was especially evident in elderly patients and those with ambulatory care sensitive or chronic disorders.
Conclusions:
A system of community-based care and education has resulted in sustained gains for the Canterbury health system and freed-up hospital resources. This outcome has engendered a sense of empowerment for general practice teams and their patients.
Publisher
Cambridge University Press (CUP)
Subject
Care Planning,Public Health, Environmental and Occupational Health
Reference54 articles.
1. Randomised controlled trial of effectiveness of Leicester hospital at home scheme compared with hospital care
2. Transitional Care Interventions Prevent Hospital Readmissions For Adults With Chronic Illnesses
3. Steps towards more integrated care in New Zealand: a general practice perspective;Toop;British Journal of General Practice Open,2017
4. Timmins N and Ham C (2013) The quest for integrated health and social care: A case study in Canterbury, New Zealand: The King’s Fund. Retrieved on 18 December 2018 from https://www.kingsfund.org.uk/publications/quest-integrated-health-and-social-care
5. Stats NZ (2013) The New Zealand Census of Population and Dwellings. Retrieved on 18 December 2018 from: https://www.stats.govt.nz/
Cited by
12 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献