Residents of post-acute and long-term care (PALTC) facilities with same-day physician access experienced lower hospitalization and emergency department (ED) visit rates than those with longer wait times, according to a study published in the April issue of JAMDA.
In Physician Availability in Long-Term Care Facilities and Resident Hospital Transfer: A Retrospective Cohort Study, the authors administered a survey to Ontario, Canada, long-term care facilities during a three-month period about their typical wait time for physician visits. A total of 52 facilities (32%) reported same-day physician access.
According to the study, residents of homes with same-day physician access had a 14% lower rate of ED visits and a 21% lower rate of hospitalizations than individuals in facilities without this capability.
The authors also found that availability of nurse practitioners (NPs) who can assess and treat residents was independently associated with fewer ED visits and hospitalization; although they noted that 60% of homes without same-day physician access didn’t have NP access either. The researchers suggested that many transfers could be prevented if all facilities had urgent access to either a physician or an NP.
“We estimate that nearly one in six hospital admissions could be prevented if all [PA]LTC homes had same-day [physician] access. The potential impact is large because the effect size is large and the prevalence of same-day physician access is low in the study population,” said the authors. They further noted that their findings suggest that improving urgent physician access in PALTC facilities could be cost-effective as well.
This study was conducted by researchers at the Department of Medicine, Division of General Internal Medicine, Ottawa Hospital, Ottawa, Ontario, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; The Ottawa Hospital, Department of Medicine, Ottawa, Ontario, Canada; University of Ottawa, School of Epidemiology & Public Health, Ottawa, Ontario, Canada; Bruyere Research Institute, Bruyere Centre of Learning, Research and Innovation in Long-Term Care, Ottawa, Ontario, Canada.
Click here for more information on the findings above and more details about the study. To contact the researchers or JAMDA editor for an interview, please email emullally@paltc.org.
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About JAMDA
JAMDA is the official journal of AMDA – The Society for Post-Acute and Long-Term Care Medicine. JAMDA publishes peer-reviewed articles including original studies, reviews, clinical experience articles, case reports, and more, on all topics more important to post-acute and long-term care medicine. Visit www.jamda.com for more information.
About AMDA – The Society for Post-Acute and Long-Term Care Medicine AMDA – The Society for Post-Acute and Long-Term Care Medicine is the only medical specialty society representing the community of over 50,000 medical directors, physicians, nurse practitioners, physician assistants, and other practitioners working in the various post-acute and long-term care (PALTC) settings. Dedicated to defining and improving quality, we advance our mission through timely professional development, evidence-based clinical guidance, and tireless advocacy on behalf of members, patients, families, and staff. Visit www.paltc.org for more information.
