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Restorative Care01:19

Restorative Care

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Restorative care is provided once a patient has been discharged from a healthcare facility and requires additional services. The additional services include home care, rehabilitation programs, and extended care. Restorative care centers help the patient regain their previous level of functioning or acquire a new level of functioning due to the incapacitating effects of a disease or a disability. It aims to assist patients in enhancing their quality of life by encouraging independence,...
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Discharge Summary Forms01:31

Discharge Summary Forms

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The discharge summary is crucial as it enables a smooth transition from a healthcare facility to a patient's home or another care setting. This critical document facilitates seamless continuity of care, ensuring patients receive the necessary support and attention.
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
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Methods Of Healthcare Delivery System01:26

Methods Of Healthcare Delivery System

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At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
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Healthcare Associated Infections II: Preventive Measures01:22

Healthcare Associated Infections II: Preventive Measures

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Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
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Traditional Level Of Health Care System01:26

Traditional Level Of Health Care System

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The levels of care describe the services provided in the healthcare system. Accordingly, there are six levels of the traditional healthcare system in the US: preventive, primary, secondary, tertiary, restorative, and continuing healthcare. A nurse must understand how the healthcare industry organizes and provides services within these levels of care.
The preventive healthcare service includes tests for screening. Preventive health care services include identifying and reducing disease risk...
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Tertiary Healthcare System01:21

Tertiary Healthcare System

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Specialized care provided over an extended period is called tertiary care. Usually, a primary or secondary care physician will refer a patient to tertiary care. A patient's maximum physical and mental function is restored in tertiary care, which is caused due to the impact of a chronic illness or condition. Tertiary care aims to achieve the highest level of functioning possible while managing chronic illness. For example, a patient who falls and fractures their hip will need secondary care...
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Related Experiment Video

Updated: Jun 8, 2025

Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
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Transitional Care Program in Reducing Acute Hospital Utilization in Singapore.

Chong Yau Ong1, Jun Jie Angus Ng1, Kar Kwan Sandra Joanne Ng2

  • 1Transitional Care Community Medicine, Population Health & Integrated Care, Sengkang General Hospital, Singapore 544886, Singapore.

Healthcare (Basel, Switzerland)
|November 9, 2024
PubMed
Summary

Transitional home care programs significantly reduce hospital admissions and emergency department visits for patients. This study shows consistent effectiveness, even during the COVID-19 pandemic, offering a scalable model for healthcare planning.

Keywords:
care continuityhealth programhome carehome visithospital admissionmultimorbiditytransitional care

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Area of Science:

  • Healthcare Management
  • Geriatric Care
  • Public Health

Background:

  • Evidence for transitional care's impact on acute hospital use is inconsistent.
  • A growing aging population necessitates local and regional evaluations of home care programs.
  • This study addresses the need to assess transitional home care effectiveness from an acute tertiary hospital.

Purpose of the Study:

  • To evaluate the effectiveness of a transitional home care program in reducing acute hospital utilization.
  • To analyze the impact on emergency department re-attendances and hospital admissions.
  • To assess program outcomes across different phases, including the COVID-19 pandemic.

Main Methods:

  • A pre-post study design was employed to assess program effectiveness.
  • 2004 enrolments from 1679 unique patients were analyzed.
  • The program involved telephone follow-up and home visits, with data analyzed using the Wilcoxon Signed-Rank Test.

Main Results:

  • Significant reductions in emergency department re-attendances: 31.2% during enrolment and 71.9% post-enrolment (p < 0.001).
  • Significant reductions in hospital admissions: 38.7% during enrolment and 76.2% post-enrolment (p < 0.001).
  • No significant difference in length of stay for admitted patients (p = 0.23).

Conclusions:

  • The transitional home care program effectively reduces emergency department re-attendances and inpatient admissions.
  • The program demonstrated a significant decrease in both total and frequent emergency department visits.
  • Consistent positive outcomes were observed during and after the COVID-19 pandemic, supporting program scalability.