ArticlePrimary health care research & development2019
Hospital avoidance: an integrated community system to reduce acute hospital demand.
Article in Primary health care research & development, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- What Is Important to Older People When Accessing Urgent Health Care: Key Considerations and Recommendations From Consumer Consultations.Health expectations : an international journal of public participation in health care and health policy · 2025Article
- "I would be very proud to be part of an initiative that didn't exclude people because it was hard": mapping and contextualising health equity responsibilities and decision-making tensions in the implementation of a multi-level system reform initiative.International journal for equity in health · 2025Article
- Evaluating a new emergency department avoidance service for older people: patient and relative experiences.Emergency medicine journal : EMJ · 2023Article
- GIS-based approaches on the accessibility of referral hospital using network analysis and the spatial distribution model of the spreading case of COVID-19 in Jakarta, Indonesia.BMC health services research · 2020Article
- A flexible protocol for a systematic review of remote patient monitoring.Primary health care research & development · 2020Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGrowth in emergency department (ED) attendance and acute medical admissions has been managed to very low rates for 18 years in Canterbury, New Zealand, using a combination of community and hospital avoidance strategies. This paper describes the specific strategies that supported management of acutely unwell patients in the community as part of a programme to integrate health services.
interventionCommunity-based acute care was established by a culture of close collaboration and trust between all sectors of the health system, with general practice closely involved in the design and management of the services, and support provided by hospital specialists, coordination and diagnostic units, and competent informatics. Introduction of the community-based services was aided by a clinical guidance website and an education programme for general practice teams and allied health professionals. OUTCOMES: Attendance at EDs and acute medical admission rates have been held at low growth and, in some cases, shorter lengths of hospital stay. This trend was especially evident in elderly patients and those with ambulatory care sensitive or chronic disorders.
conclusionsA system of community-based care and education has resulted in sustained gains for the Canterbury health system and freed-up hospital resources. This outcome has engendered a sense of empowerment for general practice teams and their patients.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.