Funded hospital discharges to care homes: a cohort study
- PMID: 37505990
- PMCID: PMC10378721
- DOI: 10.1093/ageing/afad135
Funded hospital discharges to care homes: a cohort study
Abstract
Background: Optimising timely discharge from hospitals is an international priority. In 2020, the Coronavirus disease 2019 (COVID-19) pandemic resulted in the United Kingdom Government implementing the Discharge to Assess (D2A) model across England. This funded temporary care home placement to allow further recovery and assessment of care needs outside of the hospital.
Objectives: Determine if older adults discharged from hospital to care homes after implementation of D2A differ in their characteristics or outcomes.
Design and methods: Two cohorts of older adults discharged from hospital to care homes pre- and post-implementation of the D2A model (n = 244), with 6 months of follow-up. Data were extracted from routinely collected healthcare records.
Results: The mean duration of the hospital admission was reduced (29 vs. 23 days (P = 0.02)) but discharges to care homes did not increase with implementation of D2A (n = 161 in both cohorts prior to exclusions). In July-December 2020 (post-implementation), 28% of people were living in a private residence 6 months post-discharge, compared with 18% in the same period in 2019 (P = 0.09). When those who died were excluded, this changed to 40 vs. 28% (P = 0.19). There was no change in 6-month mortality (26 vs. 35% (P = 0.17)), and no increase in readmission rate (0.48 vs. 0.63 (P = 0.21) readmissions-per-patient over 6 months). No differences in key characteristics were found. However, patients were placed in care homes further from admission addresses (17.3 vs. 9.8 km (P = 0.00001)).
Conclusions: Implementation of D2A did not result in poorer outcomes but was associated with a reduced length of hospital stay.
Keywords: Discharge to Assess; care homes; hospital discharges; older people; social care.
© The Author(s) 2023. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.
Conflict of interest statement
None.
References
-
- HM Government . COVID-19 Hospital Discharge Service Requirements. England, 2020; 1–43. https://assets.publishing.service.gov.uk/government/uploads/system/uploa....
-
- HM Government . Hospital Discharge and Community Support Guidance. England, 2022. nationalarchives.gov.uk/doc/open-government-licence/version/3%0AWhere.
-
- Bolton J. Reducing delays in hospital transfers of care for older people Key messages in planning and commissioning: Discussion paper, September 2018 Institute of Public Care, Oxford Brookes University, Oxford. https://ipc.brookes.ac.uk/publications/reducing-delays-in-hospital-trans....
-
- HM Government . Hospital Discharge Service: Policy and Operating Model. England, 2020. https://assets.publishing.service.gov.uk/government/uploads/system/uploa....
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Medical