T.L.BOH1, Y.L.FOONG1, K.R.THAM1, J.M.YU1, E.Y.B1, M.Y.LOW1, Y.H.ANG1
Khoo Teck Puat Hospital1
Medical Home (MH) programme targets patients stabilised at KTPH’s Emergency Department (ED)/ Extended Diagnostic Treatment Unit (EDTU)/Acute Geriatric Assessment Unit (AGAU), who would otherwise have been admitted for further treatment. Instead, they are discharged home and visited by MH’s multidisciplinary team, comprising doctors, nurses and therapists. The service provides 24/7 phone support and daily home reviews as required. Patients already under KTPH’s Ageing-in-Place Community Care Team (AIP-CCT), who develop acute medical problems but wish to be treated at home, can also be recruited. This abstract aims to evaluate if MH is able to provide an alternative to acute hospital admission at a lower cost with comparable health outcomes.
216 patients completed the MH intervention from May 2019 – Jun 2021. Each patient was assigned a primary diagnosis (or the main reason for recruitment into the programme). The patients were compared with a propensity score-matched cohort who received inpatient hospital care (controls). The main outcome measures were (a) 30-day readmission rates back to the acute hospital and (b) healthcare cost from the patient’s and health system’s perspectives.
MH patients showed a slightly higher 30-day readmission rate to acute hospitals as compared to inpatient control group (17% vs 14%). The MH programme costs the health system $2135/patient, 40% lesser ($1430/patient) (P<0.005) than the traditional inpatient stay of $3566/patient. The patient’s bill size of $347 was also 70% lower ($821/patient) (P<0.005) than that of the inpatient counterpart of $1169.
MH may be a lower-cost alternative to inpatient care for appropriate patients requiring hospital admission.