Table 1
Baseline Patient Demographics and Acute Hospital Utilization Rates.
| Characteristics | Control (n = 625) | Intervention (n = 541) | p-value |
|---|---|---|---|
| Age, mean (SD) | 79.0 (10.8) | 79.3 (11.2) | 0.627 |
| Gender, n (%) | |||
| Female | 392 (62.7%) | 342 (63.2%) | 0.861 |
| Male | 233 (37.3%) | 199 (36.8%) | |
| Ethnicity, n (%) | |||
| Chinese | 525 (84.0%) | 429 (79.3%) | 0.001 |
| Malay | 43 (6.9%) | 71 (13.1%) | |
| Indian | 41 (6.6%) | 36 (6.7%) | |
| Others | 16 (2.6%) | 5 (0.9%) | |
| Rental Housing Status, n (%) | |||
| No | 469 (75.0%) | 377 (69.7%) | 0.041 |
| Yes | 156 (25.0%) | 164 (30.3%) | |
| Charlson Comorbidity Index Score, mean (SD) | 2.8 (2.3) | 3.7 (2.8) | <0.001 |
| Admit Source Type, n (%) | |||
| A&E | 571 (91.4%) | 503 (93.0%) | 0.307 |
| Non A&E | 54 (8.6%) | 38 (7.0%) | |
| Admit Type, n (%) | |||
| Emergency | 571 (91.4%) | 502 (92.8%) | 0.368 |
| Non-Emergency | 54 (8.6%) | 39 (7.2%) | |
| Admit Class, n (%) | |||
| Class A | 22 (3.5%) | 9 (1.7%) | 0.051 |
| Class B1 | 30 (4.8%) | 15 (2.8%) | |
| Class B2 | 299 (47.8%) | 259 (47.9%) | |
| Class C | 274 (43.8%) | 258 (47.7%) | |
| Length of Stay (LOS), mean (SD) | 11.2 (13.2) | 10.3 (12.9) | 0.209 |
| No of admissions | |||
| 1 year before index admission/THC start date, mean (SD) | 1.5 (1.9) | 1.7 (2.0) | 0.183 |
| 180 days before index admission/THC start date, median (range) | 1 (0–7) | 1 (0–8) | 0.116 |
| 90 days before index admission/THC start date, mean (SD) | 0.5 (0.9) | 0.6 (0.8) | 0.502 |
| 30 days before index admission/THC start date, mean (SD) | 0.2 (0.6) | 0.1 (0.4) | <0.001 |
| No of ED visits | |||
| 1 year before index admission/THC start date, mean (SD) | 2.6 (2.3) | 2.7 (2.2) | 0.252 |
| 180 days before index admission/THC start date, mean (SD) | 1.9 (1.6) | 2.0 (1.5) | 0.337 |
| 90 days before index admission/THC start date, mean (SD) | 1.5 (1.0) | 1.5 (1.0) | 0.369 |
| 30 days before index admission/THC start date, mean (SD) | 1.2 (0.7) | 0.8 (0.7) | <0.001 |
| No of SOC visits | |||
| 1 year before index admission/THC start date, mean (SD) | 4.7 (6.7) | 5.7 (7.7) | 0.026 |
| 180 days before index admission/THC start date, mean (SD) | 2.4 (3.6) | 2.9 (4.0) | 0.017 |
| 90 days before index admission/THC start date, mean (SD) | 1.3 (2.1) | 1.6 (2.2) | 0.017 |
| 30 days before index admission/THC start date, mean (SD) | 0.5 (0.9) | 0.6 (1.0) | 0.035 |
[i] SD: standard deviation; ED: emergency department; SOC: Specialist Outpatient Clinic; p < 0.05 (Statistically significant).
Table 2
Overall difference in the proportion of patients with hospital utilization within 30 days after index hospitalization.
| Outcome Measures | Control n = 625 | Intervention n = 541 | p-value |
|---|---|---|---|
| Admissions, n (%) | 120 (19.2%) | 71 (13.1%) | 0.005 |
| ED attendances, n (%) | 124 (19.8%) | 82 (15.2%) | 0.037 |
| SOC attendances, n (%) | 286 (45.8%) | 234 (43.3%) | 0.390 |
[i] ED: emergency department; SOC: Specialist Outpatient Clinic; p < 0.05 (Statistically significant).
Table 3
Odds Ratio from Stepwise Multiple Logistic Regression Modeling, adjusted for other significant predictors.
| Outcome Measures | Intervention group (Reference: Control group) | |
|---|---|---|
| Adjusted Odds Ratio (95% CI) | p-value | |
| 30 days readmission* | 0.62 (0.44–0.86) | 0.004 |
| 30 days ED attendance | 0.67 (0.49–0.92) | 0.013 |
| 30 days SOC attendance | 0.81 (0.63–1.03) | 0.090 |
| 90 days readmission | 0.72 (0.55–0.93) | 0.012 |
| 90 days ED attendance | 0.76 (0.59–0.98) | 0.037 |
| 90 days SOC attendance | 0.86 (0.66–1.13) | 0.291 |
[i] *: Primary outcome measure; ED: emergency department; SOC: Specialist Outpatient Clinic; p < 0.05 (Statistically significant).
Table 4
Subgroup analyses for Admission and ED attendance within 30 days.
| Outcome: Admission within 30 days | Control n = 625 | Intervention n = 541 | Odds Ratio (95% CI) | p-value for interaction |
|---|---|---|---|---|
| Subgroup: Charlson Score | ||||
| Charlson Score: 0–2 | 51 (15.6%) | 31 (14.6%) | 0.93 (0.55–1.54) | 0.009 |
| Charlson Score: 3–5 | 46 (21.7%) | 24 (11.3%) | 0.46 (0.26–0.81) | |
| Charlson Score >5 | 23 (27.1%) | 16 (13.8%) | 0.43 (0.20–0.93) | |
| Outcome: A&E attendances within 30 days | Control n = 625 | Intervention n = 541 | Odds Ratio (95% CI) | p-value for interaction |
| Subgroup: Gender | ||||
| Female | 87 (22.2%) | 44 (12.9%) | 0.52 (0.34–0.78) | 0.007 |
| Male | 37 (15.9%) | 38 (19.1%) | 1.25 (0.74–2.12) | |
| Subgroup: Charlson Score | ||||
| Charlson Score: 0–2 | 58 (17.7%) | 36 (16.9%) | 0.95 (0.58–1.53) | 0.047 |
| Charlson Score: 3–5 | 42 (19.8%) | 27 (12.7%) | 0.59 (0.33–1.03) | |
| Charlson Score > 5 | 24 (28.2%) | 19 (16.4%) | 0.50 (0.24–1.04) | |
| Subgroup: No. of admissions 30 days before | ||||
| 0 admissions | 95 (18.7%) | 60 (12.6%) | 0.63 (0.43–0.90) | 0.024 |
| 1 or more admissions | 29 (24.8%) | 22 (33.3%) | 1.52 (0.74–3.09) | |