Effectiveness of an assess and restore program in treating older adults with physiological and functional decline:...

The study aimed to determine the effectiveness of an "assess and restore" model, Humber's Elderly Assess and Restore Team (HEART) program, in reducing length of stay, avoiding becoming designated as alternate level of care (ALC), facilitating home discharge, and reducing hospital readmissions.

The electronic health records of community-dwelling adults aged ≥65 years admitted to a large community hospital from September 4, 2018 to March 31, 2020 were extracted. Propensity score matching was used to compare HEART participants and patients eligible for the program who did not participate in terms of excessive length of stay, ALC status, discharge destination, 30-day hospital readmission, and 30-day visits to the emergency department. Mann-Whitney U tests and regression analyses were used to determine associations between HEART participation and outcome variables.

After propensity score matching, 1094 patients were included: 547 HEART participants and 547 non-participants. Compared to non-participants, HEART patients had a lower excessive length of stay (Mdn=0.1 vs 0.5 days, p=.04), were less likely to become ALC (OR=0.30, 95% CI=0.13-0.69), and were more likely to be discharged home (OR=2.85, 95% CI=2.03-3.99). HEART participation was not associated with 30-day readmission to the hospital nor emergency department visits.

The HEART program can preserve hospital resources and reduce the need for further rehabilitative care but does not affect future visits to the hospital. An assess and restore program may be beneficial in the care of hospitalized older adults.