Program keeps elderly Queenslanders out of emergency
A medical program developed at the Royal Brisbane and Women’s Hospital is successfully keeping elderly aged care residents out of hospital and reducing demand on emergency departments.
RBWH Emergency and Trauma Centre Senior Staff Specialist Dr Bill Lukin evaluated the Hospital in the Nursing Home program and found the number of visits to the Emergency and Trauma Centre reduced significantly.
“The program led to an average 17 per cent decrease in aged care patients presenting to the RBWH Emergency and Trauma Centre, a 36 per cent drop in hospital admissions per emergency presentation and an overall 47 per cent decrease in hospital admissions,” he said.
“That’s about one ward of elderly people each month who are no longer being admitted to hospital.
“We also found the program is cost effective, delivering RBWH about $8 million a year in economic benefits after costs or a return of $17 for every $1 invested.
“Most importantly, getting treatment at home is almost always better for an elderly patient.”
Backed by a $290,000 grant from the Emergency Medicine Foundation (EMF), funded by Queensland Health, Dr Lukin led a research team to evaluate the impacts of the program, which was rolled out across aged care facilities in Brisbane.
Minister for Health and Ambulance Services Steven Miles said many elderly patients were sent to the emergency department by aged care homes for relatively routine procedures such as changing catheters, wound care or providing blood transfusions.
“The beauty of the Hospital in the Nursing Home program is it enables these more common procedures to be performed in the aged care facilities,” Minister Miles said.
“Through the program, GPs and nursing staff at aged care facilities are provided with education and support to further manage the acute care of their residents, including having access to a contact person in the ED for advice.
“This is an excellent example of state-run and privately-run facilities working together to improve the health and wellbeing of elderly Queenslanders.”
In Brisbane, the program was rolled out across aged care facilities which combined care for more than 2000 elderly residents. Similar programs have also been established in Metro South and on the Sunshine Coast.
EMF Director Dr Anthony Bell said Dr Lukin’s research would enable vital emergency medical resources to be allocated more effectively.
“Dr Lukin’s research clearly shows that extra training and support can enable elderly Australians to access high-quality healthcare services without needing to leave their homes,” he said.
“When emergency departments, hospitals and community health providers work together providing the best possible care for older Australians in their home, everyone benefits.
“Emergency and hospital beds are freed up and older patients are not unnecessarily coming into an unfamiliar and often stressful environment.”
An economic evaluation of the program was recently published in the July edition of the journal, PLoS ONE.
Since the program started in Brisbane, similar programs have been developed in Metro South and on the Sunshine Coast.
- The Emergency Medicine Foundation (EMF) is an Australian non-profit organisation which funds innovative, evidence-based emergency medicine research.
- EMF runs two research grant programs – a national Rural and Remote program and a highly successful Queensland program – as well as a Research Support Network.
Key research publications:
> Fan L., Lukin B., Zhao J., Sun J., Dingle K., Purtill R., Tapp S., Hou X. Y., “Cost analysis of improving emergency care for aged care residents under a Hospital in the Nursing Home program in Australia”, PLoS ONE 13(7):e0199879. doi.org/10.1371/journal.pone.0199879
> Fan L., Hou X. Y., Zhao J., Sun J., Dingle K., Purtill R., Tapp S., Lukin B., “Hospital in the Nursing Home program reduces emergency department presentations and hospital admissions from residential aged care facilities in Queensland, Australia: a quasi-experimental study”, BMC Health Services Research, 2016;16:46. doi: 10.1186/s12913-016-1275-z