Aims
To implement a model of care, providing medical, nursing and allied health care in the home as part of a Virtual Aged Care Assessment Unit (Virtual ACAU) for geriatric inpatients at The Sutherland Hospital.
Methods
Patients were recruited within the first 72 hours of their admission. Patients were eligible for inclusion if they were being discharged into the community, were medically stable for discharge and would have otherwise remained in hospital for allied health or medical input. Home visits were conducted in the days following discharge with input from medical, nursing, physiotherapy, occupational therapy, and social work staff. Health outcome measures included length of stay (including inpatient and time spent on program) and readmission rate and were compared to data for hospital inpatients over the same time-period. Acceptability was measured assessed using satisfaction surveys.
Results
138 patients were recruited with a mean age of 87 years. We found an average length of stay of 6.5 days and readmission rate 13%, compared to 7.3 days and 13% for hospital inpatients. Patients received an average of 4.6 home visits and 3.4 phone calls while on the program. Patient satisfaction was very high with 98% (50/51) of responses stating they felt adequately supported.
Conclusions
The Virtual ACAU program was able to safely provide care at home with high patient satisfaction, a comparable length of stay and without increased rates of readmission. A hospital-in-the-home program incorporating allied health input in a geriatric population may present a cost-effective alternative to inpatient care.