Multi-Purpose Services: Model for smaller hospital integrated care / Servicios Multi-propositos: Modelo para pequeños hospitales en atención integrada

Introduction: Of the 762 public hospitals in Australia, 71% have less than fifty beds.These smaller hospitals, in most cases, were built decades ago and little or no attempt has been made to redesign them.There is little, if any, research or studies into their operation, mostly no plans for their future and how they could become hubs for integrated care.There is however an exception to this.This presentation describes this exception and how this knowledge was derived.Method: This doctoral research investigated the role of the smaller public hospitals to contribute to a better understanding of factors driving change in rural hospitals and characteristics that assist them to be viable and sustainable.A sample of 25 small rural hospitals, of different sizes and throughputs, were examined in detail through quantitative analysis of retrospective data over an eleven year period.The response of these facilities to their catchment populations' needs were examined in detail for a range of factors.As part of the study an instrument -the Hospital Supply Index (HSI) -was developed to measure whether a public hospital was responding to the contemporary healthcare needs of its catchment population and was likely to be sustainable into the future.Results: Among the hospitals examined, one group stood out.These were called Multi-Purpose Services (MPS).In these facilities the entire service: aged care; in-hospital care; out of hospital care; primary health care; and social services are integrated and work 'as one'.Discussion: Out of the sample of 25 hospitals in the study, the six MPSs were 'different'.These hospitals had reinvented themselves and were the exceptions to the trend.The index showed they were sustainable services, responding to the needs of the population (HSI of >40) and the community relied heavily on their services.The care provided by these facilities was significantly different to other hospitals of similar size.On investigation it was found that these MPS hospitals had certain characteristics that made them different.These primarily related to integration.The facilities had co-located the care the patients needed on one site.They had: a single management structure for all elements of care (inpatient hospital care, aged care, outpatient community care, and social services); they had a single budget; the management was able to move resources to follow the patient's needs; the workforce worked closely together, met regularly and collaborated; the care of the patient came first; and there were structures and organisational arrangements to support patient-centred care. PowerPoint presentationhttp://integratedcarefoundation.org/

Abstract licence: CC BY

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