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Measuring the impact of step down intermediate care on delayed discharge

An interrupted time series analysis

Bibliographic Data

ID11178014
AuthorsKate Levin (0000-0002-7889-3289, NHS Greater Glasgow and Clyde, Glasgow, UK, corresponding author), Emilia Crighton (NHS Greater Glasgow and Clyde, Glasgow, UK)
Year2019
Volume73
Issue7
Pages674-679
Publication date2019-07-01
Open AccessNo
TypeARTICLE
VenueJournal of Epidemiology and Community Health (JOURNAL)
Journal identifiersISSN: 0143-005X • E-ISSN: 1470-2738
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/jech-2018-211628
PMID31005903
OpenAlexW2938050124
LanguageEN
Citations received1
References cited27

BACKGROUND: Intermediate care (IC) acts as a bridging service between hospital and home, for those deemed medically fit for discharge but who are delayed in hospital. The aim of this study was to measure the effect of IC and a 72-hour discharge target on days delayed. METHODS: Rate of days delayed per 1000 population aged 75 years+ in Glasgow City was compared before and after onset of IC with a 6-month phase-in period, using segmented linear regression. Inverclyde and West Dunbartonshire (IWD) was a control. Autoregressive and moving average terms were included in the model, as well as a Fourier term to adjust for seasonality. RESULTS: Prior to IC, rate of days delayed increased in both Glasgow City and the rest of Scotland. There was a large reduction in rate of days delayed in Glasgow during the phase-in period, greater than the rest of Scotland but comparable with that observed in IWD, with subsequent increases thereafter. Adjusting for changes in IWD, the impact of IC and the discharge target in Glasgow City was a level change of -15.20 (95% CI -17.52 to -12.88) and a trend change of -0.29 (95% CI -0.55 to -0.02). This is equivalent to a predicted reduction due to IC of -16.04 days delayed per 1000 population per month, in June 2016, and a relative reduction of 35%. CONCLUSION: IC and the 72-hour discharge target were associated with a reduction in days delayed. Rate of days delayed continued to increase over time, although at a slower rate than if IC had not been implemented

Interrupted Time Series Analysis · Population · Statistics · Frailty in Older Adults · Geriatric Care and Nursing Homes · Medicine · Primary Care and Health Outcomes · Surgery

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Citations per year1
Citation span2025 - 2025 (1)
Highly citedNo

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