G2TT
来源类型Report
规范类型报告
DOIhttps://doi.org/10.7249/RR2231
来源IDRR-2231-GST
Southwark and Lambeth Integrated Care: Evaluation of the Older People's Programme Final report
Josephine Exley; Emma Pitchforth; Miaoqing Yang; Gary A. Abel; Silvia C. Mendonca; Martin Roland
发表日期2019-03-22
出版年2019
页码74
语种英语
结论
  • There was evidence of reduced A&E attendance in the fourth year of the programme compared to that expected in the absence of the intervention but no evidence of reduced emergency admissions.
  • The costs of the programme were £149 per resident aged 65 and over but the savings in hospital costs were only £86 per resident aged 65 and over, equivalent to a net increase in health service expenditure of £64 per resident.
  • The number of Holistic Assessments carried out by GPs and consequent Integrated Care Management were both associated with significant increases in elective activity and costs.
摘要

The study aims to estimate the impact on secondary care utilisation and costs of the Older People's Programme; a multi-faceted primary care intervention, including Holistic Assessments and Integrated Care Management packages for older people identified as being at higher risk of avoidable hospitalisation. Based on an observational study among 94 GP practices in Southwark and Lambeth and 263 control practices from other parts of England, GP practice level data were analysed from 2009 to 2016 (intervention operated from 2012-2016). The results showed that there was evidence of reduced A&E attendance in the fourth year of the programme compared to that expected in the absence of the intervention, but no evidence of reduced emergency admissions. Overall, outpatient attendances and elective admissions were reduced by the end of the programme. The costs of the programme were £149 per resident aged 65 and over but the savings in hospital costs were only £86 per resident aged 65 and over, equivalent to a net increase in health service expenditure of £64 per resident. The number of Holistic Assessments carried out by GPs and consequent Integrated Care Management were both associated with significant increases in elective activity and costs. The Older People's Programme was not cost-saving. Some aspects of the Programme were associated with increased costs of elective care, possibly through the identification of unmet need. Interventions to improve integration of care are more likely to be judged successful if the aim is to improve quality of care rather than reduce cost.

目录 Southwark and Lambeth Integrated Care: Evaluation of the Older People's Programme Final report | RAND
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主题Health Care Program Evaluation ; Integrated Care ; Measuring Health Care Costs ; Older Adults ; United Kingdom
URLhttps://www.rand.org/pubs/research_reports/RR2231.html
来源智库RAND Corporation (United States)
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资源类型智库出版物
条目标识符http://119.78.100.153/handle/2XGU8XDN/523762
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GB/T 7714
Josephine Exley,Emma Pitchforth,Miaoqing Yang,et al. Southwark and Lambeth Integrated Care: Evaluation of the Older People's Programme Final report. 2019.
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