Providing acute care in an Acute Geriatric Community Hospital (AGCH) might lead to a reduction in these negative outcomes, as person-centered needs and goals are assessed (CGA + ACP) and acute medical treatment is provided in combination with early rehabilitation. This is done in an adapted environment (e.g. delirium preventive single rooms) and by an interdisciplinary team of professionals, who work in a transmural context to ensure streamlined transitions of care.
In 2018 the first geriatrician-led AGCH was introduced in the Netherlands, partnering with an academic hospital (Amsterdam UMC), an insurance company (Zilveren Kruis) and a home care and nursing home agency (Cordaan). Patients were actively involved in the development of the concept and the design of the AGCH was theoretically inspired and informed by knowledge accumulated by our research line.
The first research results on this AGCH in Amsterdam show that admission to an AGCH is associated with a decreased delirium incidence rate compared to a control group found in literature. Also, interim results of a prospective cohort study show a positive relation between AGCH admission and a decrease in readmissions within 90 days after discharge. Moreover, 70% of the patients admitted to the AGCH are on the same level of ADL functioning after three months as before admission. Research on patient satisfaction with the AGCH shows that patients (n=152) experience the admission to the AGCH as positive and are satisfied with the care, treatment, guidance and approachability the AGCH offers. They also suggest to implement this type of care elsewhere.
To assess whether the concept of the AGCH can be successfully implemented in other regions in the Netherlands, the National Learning Network Acute Elderly Care has been established by the initiators (Amsterdam UMC, Cordaan, and Zilveren Kruis) and with support of the Ministry of Health, Welfare and Sports. In this network, 9 pioneer sites (including the AGCH in Amsterdam) work together on further development of the AGCH. With the aim to scientifically inform further development of the AGCH concept and to gather evidence about the transferability of the intervention to other contexts, a feasibility study is planned to the implementation of the AGCH in the pioneer sites.
Contact person: Eline Kroeze e.d.kroeze@amsterdamumc.nl
