Transitional Care Program in Reducing Acute Hospital Utilization in Singapore

• Published in: Healthcare (Basel) 2024-11, Vol.12 (21), p.2144
• Main Authors: Ong, Chong Yau, Ng, Jun Jie Angus, Ng, Kar Kwan Sandra Joanne, Tay, Pei Yoke, Lee, Mui Hua Jean
• Format: Article
• Language: English
• Subjects: Activities of daily living; Caregivers; Clinical outcomes; Control; Emergency medical care; Frailty; Health informatics; Health services utilization; Hospital utilization; Hospitals; Length of stay; Long term health care; Methods; Older people; Patients; Transitional care
• ISSN: 2227-9032; 2227-9032
• DOI: 10.3390/healthcare12212144

(1) Background: The evidence to support transitional care in reducing acute hospital utilization is variable. Despite changes in the healthcare landscape with a rapidly aging population, there is a lack of local and regional studies to evaluate the effectiveness of transitional home care programs. This study investigates whether a transitional home care program delivered by an acute tertiary hospital can reduce acute hospital utilization. (2) Methods: A pre-post design was used to evaluate the effectiveness of the program. A total of 2004 enrolments from 1679 unique patients that fulfilled the criteria of enrolment were included. The transitional care program is delivered through telephone follow-up and home visits. The Wilcoxon Signed-Rank Test was used to assess the differences between the three periods of baseline, enrolment, and post-enrolment. (3) Results: All 2004 enrolments were analyzed. The re-attendances at the emergency department reduced significantly by 31.2% and 71.9% during enrolment and post-enrolment ( < 0.001), respectively. Similarly, patients had a 38.7% and 76.2% reduction in hospital admissions during enrolment and post-enrolment ( < 0.001), respectively. For patients who were admitted, there was no significant difference in the length of stay between these groups ( = 0.23). (4) Conclusions: The transitional home care program can effectively reduce emergency department re-attendances and inpatient admissions. Not only was the total number of emergency department re-attendances reduced significantly, but the number of frequent re-attendances also dropped significantly. The outcomes were consistent during COVID-19 and post-pandemic phases. These findings can be used as a guide in program planning and future scalability.