K.THAM1, H.L.LIU1, C.C.LEE1, B.J.B.W.S.LIM2, Y.H.ANG1, T.E.Y.TANG1
Khoo Teck Puat Hospital1, Tan Tock Seng Hospital2
IMC is a relationship-based shared care model that exemplifies “care ownership’ by a single physician supported by a care coordinator. IMC targets complex patients with multiple hospital admissions and co-morbidities. This abstract aims to evaluate if IMC can provide better outcomes for complex patients through a relationship-based care ownership model and integrating clinical care with psychosocial, functional and preventive measures.
198 complex patients in the Specialist Outpatient Clinic (SOC) setting were enrolled into IMC from October 2018 to Mar 2021. Pre-post enrolment hospital utilization data were collected. Outcome measures were 1) Difference in number of hospital bed days 6-month and 1-year pre and post enrolment, 2) Difference in number of medical SOC consultation visits 6-month and 1-year pre and post enrolment.
IMC patients showed reductions in both hospital bed days and SOC visits post-enrolment. The average hospital bed days per patient 6-month and 1-year before IMC enrolment is 9.0 days and 19.7 days respectively, compared to 4.7 days and 12.9 days after IMC (P<0.005). The average medical SOC attendances per patient 6-month and 1-year before IMC enrolment is 2.6 and 5.4 respectively, compared to 2.2, and 4.4 after IMC (P<0.05).
IMC may be able to reduce hospital utilization for complex patients. Given the limitations of a pre-post analysis, a more robust evaluation using matched controls and other outcome measures such as clinical, functional outcomes and patient experience will be needed.