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Post-hospital care intervention reduces resident readmission

Fewer nursing home residents are needing to return to hospital after discharge under a program that involves regular specialist follow up.

The intervention, called Regular Early Assessment Post-Discharge (REAP), was developed by a team from St George Hospital, Calvary Health Care and UNSW’s Centre for Healthy Brain Ageing (CHeBA).

REAP sees residents receive seven regular monthly conjoint geriatrician and nurse practitioner nursing home visits for the first six months following hospital admission.

A study into the intervention’s effectiveness found REAP was associated with almost two thirds fewer hospital readmissions and half as many emergency department visits compared with controls.

Professor Henry Brodaty, study co-author and co-director of CHeBA, said that the total costs were also 50 per cent lower in the REAP intervention group.

Lead author Dr Nicholas Cordato said that re-hospitalisation of residents is costly, frequent, potentially avoidable and associated with poor survival and diminished quality of life.

Aged Care Insite spoke with Cordato, a senior lecturer at UNSW and senior staff specialist at St George and Calvary Hospitals, to find what makes the program a success and whether it should be rolled out across Australia.

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