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- W2566820595 abstract "<h3>Objectives</h3> To investigate whether implementation of municipal acute bed units (MAUs) resulting from the Norwegian Coordination Reform (2012) was associated with reductions in hospital admissions, particularly for the elderly. <h3>Design</h3> A municipality-based retrospective comparative cohort study using monthly population-based registry data analysed with fixed-effects log–log regressions. <h3>Setting</h3> Norwegian municipalities and hospitals. <h3>Population</h3> All patients admitted to secondary hospital care in Norway between 2010 and 2014, excluding psychiatric admissions, with additional focus on admission type and elderly age subgroups. <h3>Main outcome measures</h3> Monthly admission rates in total and by age group for all patients, patients admitted with acute conditions and with acute conditions at internal medicine departments. <h3>Results</h3> The introduction of MAUs was associated with a small yet significant overall negative effect on hospital admissions. The reduction in all admissions was significant for the entire population (−1.2%, 95% CI −2.0% to −0.0%) and slightly stronger for those aged 80 years and above (−1.9%, 95% CI −3.0% to −1.0%). The more detailed analysis of the elderly population aged 80 years and above revealed that effects were affected by the institutional characteristics of the MAUs. The significant effects ranged between −1.6% and −8.6%, depending on the availability of physicians on duty at the MAUs, the MAUs location or combinations thereof. <h3>Conclusions</h3> Introduction of MAUs following implementation of the Norwegian Coordination Reform in 2012 was associated with a significant reduction in hospital admissions primarily for the elderly. Our findings suggest that this type of intermediate care is a viable option in an effort to alleviate the burden on hospitals by reducing the acute secondary care admission volume. Further examinations focused on cost-effectiveness, health status of patients, number of patients treated at the MAUs and comparing other intermediate care alternatives would all add important perspectives to the issue." @default.
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- W2566820595 date "2016-12-01" @default.
- W2566820595 modified "2023-09-27" @default.
- W2566820595 title "Reinventing the community hospital: a retrospective population-based cohort study of a natural experiment using register data" @default.
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- W2566820595 doi "https://doi.org/10.1136/bmjopen-2016-012892" @default.
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