Facility and Regional Variations in Admission and Discharge Patterns Within Step-Up Intermediate Care: A Cross-Sectional Study of Municipal Inpatient Acute Care Services in Norway.
Background: Norwegian Municipal Inpatient Acute Care (MIPAC) services were established as part of the 2012 Coordination Reform. The intention was to prevent unnecessary hospital admissions by redirecting and maintaining less urgent patients at the primary care level, which provides inpatient acute h...
| Publicado en: | Health Services Insights pp. 1 - 12 |
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| Autores principales: | , , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
12/4/2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=181467552&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 181467552 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 11786329 B10H jtl: Health Services Insights issn: 11786329 maglogo: Y pubinfo: dt: 12/4/2024 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 181467552 181467552 181467552 10.1177/11786329241304565 181467552 ppf: 1 ppct: 11 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Facility and Regional Variations in Admission and Discharge Patterns Within Step-Up Intermediate Care: A Cross-Sectional Study of Municipal Inpatient Acute Care Services in Norway. aug: au: Yang, Fan Burrell, Lisa Victoria Raknes Sogstad, Maren Kristine Skinner, Marianne Sundlisæter affil: Centre for Care Research, Department of Health Sciences in Gjøvik, Norwegian University of Science and Technology (NTNU), Gjøvik, Norway sug: subj: Subacute Care Norway Patient Admission Evaluation Patient Discharge Evaluation Transfer, Discharge Evaluation Health Services Research Health Services Administration Human Norway Inpatients Hospitals, Public Cross Sectional Studies Chi Square Test Nursing Homes Hospitals Home Environment Descriptive Statistics Data Analysis Software Confidence Intervals Geographic Locations Health Care Delivery ab: Background: Norwegian Municipal Inpatient Acute Care (MIPAC) services were established as part of the 2012 Coordination Reform. The intention was to prevent unnecessary hospital admissions by redirecting and maintaining less urgent patients at the primary care level, which provides inpatient acute healthcare services closer to patients' home. However, the role MIPAC plays in the patient trajectory and how trajectories vary across different units and settings is less clear. Objective: Therefore, this study aimed to (1) describe the general patient transfer trajectories for MIPAC patients and (2) examine facility and regional variations in MIPAC patients' sources of admission and discharge destinations. Design: A cross-sectional study using aggregated register data. Methods: The study involved 36 662 admissions across 185 MIPAC units in 2019. Descriptive statistics were used to describe patient transfer trajectories, and a random-effects multinomial logistic model was applied to assess the association between facility and regional factors and patients' admission sources and discharge destinations. Results: The findings revealed distinct admission and discharge patterns based on facility and regional factors. Notably, intermunicipal units with 5 and more municipalities collaborating had higher relative risk ratios (RRR) for discharging to hospital (RRR = 1.50, 95%CI: 1.30-1.72) compared with independent MIPAC units. Large MIPAC units with more than 5 beds had increased relative risk ratios of patients admitted from the hospital than from home (RRR = 4.29, 95%CI: 1.56-11.78). Additionally, regional disparities existed, with units in the Central (RRR = 2.29, 95%CI: 1.56-3.38) and Western Norway health authorities (RRR:1.58, 95%CI: 1.22-2.06) displaying higher nursing home discharge rates than units in the South-Eastern Norway health authority. Conclusions and implications: This study confirms the Norwegian MIPAC services' adherence to admission avoidance policies and identifies significant variations in service delivery across regions and facilities. The Norwegian MIPAC model also has potential to inspire other countries in developing admission avoidance services in the primary care setting. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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