Please use this identifier to cite or link to this item: https://doi.org/10.3389/fpubh.2022.779910
Title: One-Bed-One-Team-Does an Integrated General Hospital Inpatient Model Improve Care Outcomes and Productivity: An Observational Study
Authors: Lai, Yi Feng 
Lee, Shi Qi
Tan, Yi-Roe
Lau, Zheng Yi
Phua, Jason 
Khoo, See Meng 
Gollamudi, Satya Pavan Kumar 
Lim, Cher Wee
Lim, Yee Wei 
Keywords: Science & Technology
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
integrated care
acuity transition
inpatient
care coordination
generalist
CHRONIC DISEASES
HEALTH-CARE
MULTIMORBIDITY
PREVALENCE
Issue Date: 4-Mar-2022
Publisher: FRONTIERS MEDIA SA
Citation: Lai, Yi Feng, Lee, Shi Qi, Tan, Yi-Roe, Lau, Zheng Yi, Phua, Jason, Khoo, See Meng, Gollamudi, Satya Pavan Kumar, Lim, Cher Wee, Lim, Yee Wei (2022-03-04). One-Bed-One-Team-Does an Integrated General Hospital Inpatient Model Improve Care Outcomes and Productivity: An Observational Study. FRONTIERS IN PUBLIC HEALTH 10. ScholarBank@NUS Repository. https://doi.org/10.3389/fpubh.2022.779910
Abstract: Introduction: With the increasing complexity of healthcare problems worldwide, the demand for better-coordinated care delivery is on the rise. However, current hospital-based practices remain largely disease-centric and specialist-driven, resulting in fragmented care. This study aimed to evaluate the effectiveness and feasibility of an integrated general hospital (IGH) inpatient care model. Methods: Retrospective analysis of medical records between June 2018 and August 2019 compared patients admitted under the IGH model and patients receiving usual care in public hospitals. The IGH model managed patients from one location with a multidisciplinary team, performing needs-based care transition utilizing acuity tagging to match the intensity of care to illness acuity. Results: 5,000 episodes of IGH care entered analysis. In the absence of care transition in intervention and control, IGH average length of stay (ALOS) was 0.7 days shorter than control. In the group with care transition in intervention but not in control, IGH acute ALOS was 2 days shorter, whereas subacute ALOS was 4.8 days longer. In the presence of care transition in intervention and control, IGH acute ALOS was 6.4 and 10.2 days shorter and subacute ALOS was 15.8 and 26.9 days shorter compared with patients under usual care at acute hospitals with and without co-located community hospitals, respectively. The 30- and 60-days readmission rates of IGH patients were marginally higher than usual care, though not clinically significant. Discussions: The IGH care model maybe associated with shorter ALOS of inpatients and optimize resource allocation and service utilization. Patients with dynamic acuity transition benefited from a seamless care transition process.
Source Title: FRONTIERS IN PUBLIC HEALTH
URI: https://scholarbank.nus.edu.sg/handle/10635/234595
ISSN: 2296-2565
DOI: 10.3389/fpubh.2022.779910
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