One-Bed-One-Team—Does an Integrated General Hospital Inpatient Model Improve Care Outcomes and Productivity: An Observational Study
IntroductionWith the increasing complexity of healthcare problems worldwide, the demand for better-coordinated care delivery is on the rise. However, current hospital-based practices remain largely disease-centric and specialist-driven, resulting in fragmented care. This study aimed to evaluate the...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-03-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2022.779910/full |
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| author | Yi Feng Lai Yi Feng Lai Yi Feng Lai Yi Feng Lai Shi Qi Lee Yi-Roe Tan Zheng Yi Lau Jason Phua See Meng Khoo Satya Pavan Kumar Gollamudi Cher Wee Lim Yee Wei Lim Yee Wei Lim |
| author_facet | Yi Feng Lai Yi Feng Lai Yi Feng Lai Yi Feng Lai Shi Qi Lee Yi-Roe Tan Zheng Yi Lau Jason Phua See Meng Khoo Satya Pavan Kumar Gollamudi Cher Wee Lim Yee Wei Lim Yee Wei Lim |
| author_sort | Yi Feng Lai |
| collection | DOAJ |
| description | IntroductionWith the increasing complexity of healthcare problems worldwide, the demand for better-coordinated care delivery is on the rise. However, current hospital-based practices remain largely disease-centric and specialist-driven, resulting in fragmented care. This study aimed to evaluate the effectiveness and feasibility of an integrated general hospital (IGH) inpatient care model.MethodsRetrospective analysis of medical records between June 2018 and August 2019 compared patients admitted under the IGH model and patients receiving usual care in public hospitals. The IGH model managed patients from one location with a multidisciplinary team, performing needs-based care transition utilizing acuity tagging to match the intensity of care to illness acuity.Results5,000 episodes of IGH care entered analysis. In the absence of care transition in intervention and control, IGH average length of stay (ALOS) was 0.7 days shorter than control. In the group with care transition in intervention but not in control, IGH acute ALOS was 2 days shorter, whereas subacute ALOS was 4.8 days longer. In the presence of care transition in intervention and control, IGH acute ALOS was 6.4 and 10.2 days shorter and subacute ALOS was 15.8 and 26.9 days shorter compared with patients under usual care at acute hospitals with and without co-located community hospitals, respectively. The 30- and 60-days readmission rates of IGH patients were marginally higher than usual care, though not clinically significant.DiscussionsThe IGH care model maybe associated with shorter ALOS of inpatients and optimize resource allocation and service utilization. Patients with dynamic acuity transition benefited from a seamless care transition process. |
| first_indexed | 2024-12-19T22:35:19Z |
| format | Article |
| id | doaj.art-e1cc13336b074c048d775aec5cda0b11 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-12-19T22:35:19Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-e1cc13336b074c048d775aec5cda0b112022-12-21T20:03:13ZengFrontiers Media S.A.Frontiers in Public Health2296-25652022-03-011010.3389/fpubh.2022.779910779910One-Bed-One-Team—Does an Integrated General Hospital Inpatient Model Improve Care Outcomes and Productivity: An Observational StudyYi Feng Lai0Yi Feng Lai1Yi Feng Lai2Yi Feng Lai3Shi Qi Lee4Yi-Roe Tan5Zheng Yi Lau6Jason Phua7See Meng Khoo8Satya Pavan Kumar Gollamudi9Cher Wee Lim10Yee Wei Lim11Yee Wei Lim12MOH Office for Healthcare Transformation, Singapore, SingaporeDepartment of Pharmacy, Alexandra Hospital, Singapore, SingaporeDepartment of Pharmacy, National University of Singapore, Singapore, SingaporeSchool of Public Health, University of Illinois at Chicago, Chicago, IL, United StatesDivision of Policy Research and Evaluation, Ministry of Health, Singapore, SingaporeMOH Office for Healthcare Transformation, Singapore, SingaporeDivision of Policy Research and Evaluation, Ministry of Health, Singapore, SingaporeAlexandra Hospital, National University Health System, Singapore, SingaporeAlexandra Hospital, National University Health System, Singapore, SingaporeAlexandra Hospital, National University Health System, Singapore, SingaporeMOH Office for Healthcare Transformation, Singapore, SingaporeAlexandra Hospital, National University Health System, Singapore, SingaporeDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeIntroductionWith the increasing complexity of healthcare problems worldwide, the demand for better-coordinated care delivery is on the rise. However, current hospital-based practices remain largely disease-centric and specialist-driven, resulting in fragmented care. This study aimed to evaluate the effectiveness and feasibility of an integrated general hospital (IGH) inpatient care model.MethodsRetrospective analysis of medical records between June 2018 and August 2019 compared patients admitted under the IGH model and patients receiving usual care in public hospitals. The IGH model managed patients from one location with a multidisciplinary team, performing needs-based care transition utilizing acuity tagging to match the intensity of care to illness acuity.Results5,000 episodes of IGH care entered analysis. In the absence of care transition in intervention and control, IGH average length of stay (ALOS) was 0.7 days shorter than control. In the group with care transition in intervention but not in control, IGH acute ALOS was 2 days shorter, whereas subacute ALOS was 4.8 days longer. In the presence of care transition in intervention and control, IGH acute ALOS was 6.4 and 10.2 days shorter and subacute ALOS was 15.8 and 26.9 days shorter compared with patients under usual care at acute hospitals with and without co-located community hospitals, respectively. The 30- and 60-days readmission rates of IGH patients were marginally higher than usual care, though not clinically significant.DiscussionsThe IGH care model maybe associated with shorter ALOS of inpatients and optimize resource allocation and service utilization. Patients with dynamic acuity transition benefited from a seamless care transition process.https://www.frontiersin.org/articles/10.3389/fpubh.2022.779910/fullintegrated careacuity transitioninpatientcare coordinationgeneralist |
| spellingShingle | Yi Feng Lai Yi Feng Lai Yi Feng Lai Yi Feng Lai Shi Qi Lee Yi-Roe Tan Zheng Yi Lau Jason Phua See Meng Khoo Satya Pavan Kumar Gollamudi Cher Wee Lim Yee Wei Lim Yee Wei Lim One-Bed-One-Team—Does an Integrated General Hospital Inpatient Model Improve Care Outcomes and Productivity: An Observational Study Frontiers in Public Health integrated care acuity transition inpatient care coordination generalist |
| title | One-Bed-One-Team—Does an Integrated General Hospital Inpatient Model Improve Care Outcomes and Productivity: An Observational Study |
| title_full | One-Bed-One-Team—Does an Integrated General Hospital Inpatient Model Improve Care Outcomes and Productivity: An Observational Study |
| title_fullStr | One-Bed-One-Team—Does an Integrated General Hospital Inpatient Model Improve Care Outcomes and Productivity: An Observational Study |
| title_full_unstemmed | One-Bed-One-Team—Does an Integrated General Hospital Inpatient Model Improve Care Outcomes and Productivity: An Observational Study |
| title_short | One-Bed-One-Team—Does an Integrated General Hospital Inpatient Model Improve Care Outcomes and Productivity: An Observational Study |
| title_sort | one bed one team does an integrated general hospital inpatient model improve care outcomes and productivity an observational study |
| topic | integrated care acuity transition inpatient care coordination generalist |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2022.779910/full |
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