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Updated: Oct 26, 2025

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Published on: September 30, 2020
Improved outcomes with delayed admission to post-acute care: results of a natural experiment
Siobhán McGettigan1, Amy Farrell1, Robert Murphy1
1Department of Geriatric Medicine, University Hospital, Unit 4, Merlin Park University Hospital, Galway, Republic of Ireland.
Purpose:
To determine the effectiveness of a post-acute care scheme by exploiting a natural experiment.
Methods:
We used a reduction in funding for an Irish PAC scheme based in private nursing homes as a natural experiment to explore the effectiveness of this scheme in a single large general hospital.
Results:
Compared with an equivalent 3-month period in 2017 (pre-change, N = 169), those admitted to PAC in 2019 (post-change, N = 179), spent a median 6 days longer in acute care, although total duration spent in healthcare settings was the same. Compared with 2017, readmissions to hospital within 90 days of discharge (43/179 (24.0% v 58/169 (34.3%), p = 0.03) and discharge to long-term care from the PAC facility (3 (1.7%) v 14 (8.3%), p = 0.004) were significantly lower in 2019.
Conclusion:
Our results suggest that the longer stay in acute care and shorter stay in PAC was beneficial for patients and led to improved outcomes.
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