The impact of community nursing program on healthcare utilization: A program evaluation

Area of Science:

• Gerontology
• Public Health
• Nursing Science

Background:

• The role of nurses has evolved to address the healthcare needs of an aging population.
• Community nursing services (CNP) in Singapore aim to enhance population health and provide sustainable community-based care.
• CNPs deliver health services to residents within local residential areas.

Purpose of the Study:

• To evaluate the impact of community nurse visits on healthcare utilization in older adults.
• To assess changes in utilization six months before and after the first community nurse visit.
• To determine if multiple community nurse visits or absence of polyclinic chronic disease diagnosis modify these effects.

Main Methods:

• A single-group pretest-posttest study design was employed.
• Data were collected from 51 SingHealth Community Nurse Posts in Singapore.
• 1,600 community-dwelling older adults (≥ 60 years) were included, with 1,561 completing the study.

Main Results:

• A 23% reduction in emergency department visits and a 15% reduction in unplanned inpatient admissions were observed.
• A trend towards decreased inpatient length of stay and increased specialist outpatient clinic and polyclinic visits was noted.
• Reductions in acute care utilization were more pronounced with two or more community nurse visits.

Conclusions:

• Community nursing services are linked to decreased acute care utilization among older adults, particularly those with multiple visits.
• Increased specialist outpatient clinic visits may reflect proactive referrals for new or undiagnosed conditions.
• Community nursing demonstrates potential for contributing to a more sustainable healthcare system.