ESSENCE CASE STUDY
Transition into and from hospital for people with social care needs: economic evidence
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Interventions that seek to improve the transition between hospital and other settings include: comprehensive geriatric assessments; specialist dementia / delirium unit; short-term early discharge home care and rehabilitation packages; early supported discharge with multidisciplinary community care; multi-professional palliative care.
Each has been linked to some positive outcomes – although for specialist delirium/ dementia unit and for multi-professional palliative care outcomes referred to small changes in mood, satisfaction or symptom control rather than to changes in health-related quality of life.
Early supported discharge programmes that include a rehabilitation-focused community care package are likely to be cost-effective from a combined health and social care perspective. The evidence refers to older people and people with stroke.
Comprehensive geriatric assessment and short-term rehabilitation provided to older people in hospital units may be cost-effective from a hospital perspective, but the wider impacts are unclear.
Multi-professional palliative care might be cost-effective; evidence refers to people with multiple sclerosis and people with breathlessness; there might cost savings for people with multiple sclerosis due to reductions in hospital and primary care.
A specialist delirium/ dementia unit was not cost-effective based on health-related quality of life but might importantly improve experiences of people using it and their carers.
Various national initiatives have been recently implemented to support development of innovative services to integrate care between hospitals and other settings.
This website reports on independent research funded by the NIHR School for Social Care Research.
The views expressed are those of the authors and not necessarily those of the NIHR, SSCR or the Department of Health and Social Care.