Aims: Victoria’s Geriatric Evaluation and Management (GEM) program has historically been a feature of dedicated inpatient wards which promote independence and facilitate rehabilitation of older people with multidimensional health needs. Over the past 10 years, however, the provision of GEM in a patient’s own home has become increasingly popular as an alternative service model. The aim of this project was to explore the current models of care being used in Victorian health services to support home-based GEM.
Methods: Mixed methods survey of 29 health services across metropolitan, regional and rural Victoria. A total of 23 responses were received, signifying an overall response rate of 79%. Of these, 52.2% (n=12) of health services indicated that they provide home-based GEM with 66.7% (n=8) of these located in metropolitan Melbourne.
Results: All 12 health services that provide home-based GEM used bed substitution (‘admitted episode’) as their funding model. In addition, two health services (16.7%) also utilised hospital avoidance (‘non-admitted episode’) alongside bed substitution. Despite this, the survey findings revealed that there is no ‘agreed’ model of care across Victoria, with health services establishing their own individual service profiles based on identified needs and organisational contexts.
Conclusions: Although the home environment is recognised as the preferred setting for GEM by majority of staff, patients and families, it is an emerging service model in Victoria. As a result, while there are some consistencies in processes and practice, Victoria’s home-based GEM program is continuing to evolve in response to policy directions, local innovation and demand.