When considering admitting patients over the age of 65 for acute hospital care, alternatives such as hospital at home, admission to a local community hospital or extended stays and treatment in A&E are a viable option say NIHR-funded researchers from the University of Bristol and the University for the West of England (UWE Bristol).
The research has shown that these interventions are safe, effective and have comparable mortality and clinical outcomes for patients with a range of acute and chronic conditions.
•	Hospital-type services delivered in a nursing or care home.
The researchers looked at the mortality and clinical outcomes for elderly patients with conditions such as chronic obstructive pulmonary disease (COPD), stroke, heart failure, pulmonary embolism and pneumonia. The research team found that, with the exception of stroke, these alternative are safe and can often be more cost-effective than acute hospital care. Information on costs are sparse and will differ between approaches.
The differences in outcomes for stroke patients is due to the expertise of the stroke unit staff and therefore, in line with current NICE guidance for stroke, best care needs to be provided in specialist units.
Research is ongoing within CAPC and aims to develop and pilot an alternative to hospital intervention when appropriate for older people out of the acute hospital setting.