TY - JOUR
T1 - Effect of a multidisciplinary outpatient model of care on health outcomes in older patients with multimorbidity
T2 - A retrospective case control study
AU - Shakib, Sepehr
AU - Dundon, Benjamin K.
AU - Maddison, John
AU - Thomas, Josephine
AU - Stanners, Melinda
AU - Caughey, Gillian E.
AU - Clark, Robyn A.
N1 - Publisher Copyright:
© 2016 Shakib et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2016/8
Y1 - 2016/8
N2 - Objective: To evaluate a holistic multidisciplinary outpatient model of care on hospital readmission, length of stay and mortality in older patients with multimorbidity following discharge from hospital. Design and Participants: A pilot case-control study between March 2006 and June 2009 of patients referred on discharge to a multidisciplinary, integrated outpatient model of care that includes outpatient follow-up, timely GP communication and dial-in service compared with usual care following discharge, within a metropolitan, tertiary referral, public teaching hospital. Controls were matched in a 4:1 ratio with cases for age, gender, index admission diagnosis and length of stay. Main outcome measures: Non-elective readmission rates, total readmission length of stay and overall survival. Results: A total of 252 cases and 1008 control patients were included in the study. Despite the patients referred to the multidisciplinary model of care had slightly more comorbid conditions, significantly higher total length of hospital stay in the previous 12 months and increased prevalence of diabetes and heart failure by comparison to those who received usual care, they had significantly improved survival (adjusted hazard ratio 0.70 95% CI 0.51-0.96, p = 0.029) and no excess in the number of hospitalisations observed. Conclusion: Following discharge from hospital, holistic multidisciplinary outpatient management is associated with improved survival in older patients with multimorbidity. The findings of this study warrant further examination in randomised and cost-effectiveness trials.
AB - Objective: To evaluate a holistic multidisciplinary outpatient model of care on hospital readmission, length of stay and mortality in older patients with multimorbidity following discharge from hospital. Design and Participants: A pilot case-control study between March 2006 and June 2009 of patients referred on discharge to a multidisciplinary, integrated outpatient model of care that includes outpatient follow-up, timely GP communication and dial-in service compared with usual care following discharge, within a metropolitan, tertiary referral, public teaching hospital. Controls were matched in a 4:1 ratio with cases for age, gender, index admission diagnosis and length of stay. Main outcome measures: Non-elective readmission rates, total readmission length of stay and overall survival. Results: A total of 252 cases and 1008 control patients were included in the study. Despite the patients referred to the multidisciplinary model of care had slightly more comorbid conditions, significantly higher total length of hospital stay in the previous 12 months and increased prevalence of diabetes and heart failure by comparison to those who received usual care, they had significantly improved survival (adjusted hazard ratio 0.70 95% CI 0.51-0.96, p = 0.029) and no excess in the number of hospitalisations observed. Conclusion: Following discharge from hospital, holistic multidisciplinary outpatient management is associated with improved survival in older patients with multimorbidity. The findings of this study warrant further examination in randomised and cost-effectiveness trials.
UR - http://www.scopus.com/inward/record.url?scp=84984637708&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0161382
DO - 10.1371/journal.pone.0161382
M3 - Article
C2 - 27537395
AN - SCOPUS:84984637708
SN - 1932-6203
VL - 11
JO - PloS one
JF - PloS one
IS - 8
M1 - e0161382
ER -