The Department of Aged Care, St George Hospital, Calvary Health Care and University of New South Wales (UNSW) Medicine’s Centre for Healthy Brain Ageing (CHeBA) came together to develop an “intervention”, known as the Regular Early Assessment Post-Discharge (REAP).
Consisting of seven regular monthly conjoint geriatrician and nurse practitioner nursing home visits of nursing home residents for the first six months following hospital admission, REAP aims to address the important issue of follow through care of nursing home patients after hospital discharge, an aspect of care lead author on the paper Dr Nicholas Cordato says is “generally neglected in this group”.
“Re-hospitalisation of nursing home residents is frequent, costly, potentially avoidable and associated with poor survival and diminished quality of life,” he says.
“[And] lack of specialist clinical input within facilities is a key factor.”
The research team’s randomised-controlled study on REAP to examine its effectiveness, the results of which were published in JAMDA, realised the significant benefits associated with the intervention’s implementation.
Co-author on the study and co-director of UNSW’s CHeBA, Professor Henry Brodaty, says the findings of the study were “extremely positive” with almost two-thirds fewer hospital readmissions and half as many Emergency Department visits compared with controls.
“Importantly, the total costs were 50 percent lower in the REAP intervention group, with lower total hospital inpatient and total Emergency Department costs,” he says.
The work, supported by an Establishment Grant from the St George and Sutherland Medical Research Foundation, has not yet been implemented but the evidence on its efficacy and cost-effectiveness released in the paper will be used to advocate for the intervention’s implementation.
Dr Cordato says their research group is looking to streamline these processes by focusing on aspects of the REAP intervention which appeared to be “most effective” in the analysis.
“We are now planning to undertake a follow up randomized-controlled study examining the effectiveness of this streamlined approach,” he says.
“If proven beneficial, we plan to use our findings as a platform to advocate for implementation of this intervention as standard clinical practice across all health districts.”