Transitional Care Program in Reducing Acute Hospital Utilization in Singapore.

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.