Municipal acute care teams as a flexible solution for the treatment of acutely ill patients at-home: a mixed-method study of patients' and caregivers' experiences with an acute care team

Abstract

Objective: Development of initiatives to reduce hospitalisations is a major focus of healthcare planning. Strengthening the community with municipal acute care teams or units is a newly implemented Danish initiative aimed at preventing hospitalisations and supporting more flexible services. This study aims to describe patients treated by a municipal acute care team and to explore patients' and caregivers' experiences with at-home treatment.

Design: A mixed-method study consisting of descriptive statistics of patients treated by an acute care team, and quantitative and qualitative data from follow-up telephone questionnaires with patients and caregivers.

Setting: The acute care team, 'Acute Team Odense' (ATO), in the Odense Municipality, Denmark.

Participants: Patients treated by ATO and their caregivers. ATO treated 3231 patients (5676 contacts) in the period of 2018-2019.

Results: Average number of new contacts per day was 7.8, and the median treatment-length was 1 day. Patients were referred by various healthcare providers and most often by general practitioners, municipal staff and hospital staff. The median age of the patients was 80 years, and 20% were independent before the treatment. In total, 787/5676 contacts received at-home intravenous therapy, which corresponded to 3.6 hospital beds saved per day. The questionnaires were completed by 307/478 patients and 168/254 caregivers. Most respondents stated they would prefer at-home treatment in future similar situations as it enabled them to maintain their lives. Several respondents also experienced that ATO avoided hospitalisations or reduced hospital stays, which was described as a relief.

Conclusion: ATO was frequently used, indicating the demand for community-based acute healthcare. The patients and caregivers experienced that this solution avoided hospitalisations and allowed them to maintain their lives, and this was described as less burdensome. As a result of these findings, this initiative has been continued with an ongoing focus on searching for possibilities aimed to prevent hospitalisations.

Keywords: organisation of health services; primary care; quality in health care.