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Community matrons failing to cut hospital admissions, evaluation reveals

By Gareth Iacobucci

Nurse-led case management schemes including the Government's flagship community matrons programme are failing to reduce hospital admissions in high-risk patients, an evaluation reveals.

Researchers examined the effect of case management by advanced practice nurses on unplanned hospital admission rates in patients aged 50 and over.

The study did find a small, but significant reduction – of 9% - in overall unplanned admission rates among patients who received the case management intervention.

But in high-risk patients, who were targeted to reduce the rate of multiple readmission, there was no significant effect.

The research compared the rates of unplanned medical and geriatric patient admissions at five intervention and 30 non-intervention practices during a prevention year and an intervention year.

Study leader Professor Glyn Elwyn, research director in primary care at Cardiff University, said there was little evidence that community matrons could effectively reduce multiple admissions in the UK.

‘We can make some small difference but in those patients who are the real target audience for case management, it doesn't seem to make much difference.

‘This idea came from America, but they've got a much more intensive case management approach, where they almost put in a hospital at home.

‘We don't do that, we just have nurse visits. So case management with less intervention, you might argue, doesn't seem to have an impact on multiple admissions.'

The new study, published online by BMC Health Services Research, follows the formal evaluation of the Evercare active case management programme, which also suggested community matrons were unlikely to have major effects on admissions.

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