ArticleBMJ open2016
Reinventing the community hospital: a retrospective population-based cohort study of a natural experiment using register data.
Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Providing effective and efficient hospital admission avoidance inpatient care: a systematic realist review of Norwegian municipal inpatient acute care services.BMC health services research · 2026Pooled it
- Patient experiences and clinical outcomes of admissions to municipal acute wards versus a hospital: a multicentre randomised controlled trial in Norway.Scandinavian journal of primary health care · 2024Trial
- Trends in acute specialist contacts following a primary care contact 2012-21-a registry-based study.Scandinavian journal of primary health care · 2026Article
- Facility and Regional Variations in Admission and Discharge Patterns Within Step-Up Intermediate Care: A Cross-Sectional Study of Municipal Inpatient Acute Care Services in Norway.Health services insights · 2024Article
- Finding good alternatives to hospitalisation: a data register study in five municipal acute wards in Norway.BMC health services research · 2022Article
- What if something happens tonight? A qualitative study of primary care physicians' perspectives on an alternative to hospital admittance.BMC health services research · 2021Article
- Associations between characteristics of the patients at municipal acute bed unit admission and further transfer to hospital: a prospective observational study.BMC health services research · 2020Observational
- The function of the Norwegian municipal acute units fails to fulfill the intention of health authorities.Scandinavian journal of primary health care · 2020Article
- Nursing competence in municipal in-patient acute care in Norway: a cross-sectional study.BMC nursing · 2020Article
- Nurse competence in the interface between primary and tertiary healthcare services.Nursing open · 2019Article
- First four years of operation of a municipal acute bed unit in rural Norway.Scandinavian journal of primary health care · 2018Observational
- The Impact of the Swedish Care Coordination Act on Hospital Readmission and Length-of-Stay among Multi-Morbid Elderly Patients: A Controlled Interrupted Time Series Analysis.International journal of integrated careArticle
- The Causal Effect of Community Hospitals on General Hospital Admissions. Evaluation of a Natural Experiment Using Register Data.International journal of integrated careArticle
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo 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.
designA municipality-based retrospective comparative cohort study using monthly population-based registry data analysed with fixed-effects log-log regressions.
settingNorwegian municipalities and hospitals. POPULATION: 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.
main outcome measuresMonthly admission rates in total and by age group for all patients, patients admitted with acute conditions and with acute conditions at internal medicine departments.
resultsThe 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.
conclusionsIntroduction 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.
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