More positive outcomes when elders are treated locally

Older people with health concerns frequently require some amount of intermediate monitoring, care, and treatment. While they may not need a hospital's resources, they require more advanced help than a nursing home can offer. “Intermediate care units” are primarily intended to replace an acute hospital admission but are occasionally used following admission.
Pal Erling Martinussen, a professor in the Department of Sociology and Political Science at the Norwegian University of Science and Technology (NTNU), says, “Intermediate care units are the newest trend in health policy, and Norway is way ahead of the curve in this regard.” The units are a form of middle ground between a hospital and a nursing home close to patients’ homes. Norway has established this healthcare offering in the last ten years as part of the Norwegian Coordination Reform implemented in 2012.
A group of NTNU, SINTEF and UiO researchers have now studied how this service affects various indicators that can provide evidence of the quality of Norway's health service. Martinussen said, “All Norwegian municipalities had to set up ‘municipal acute units’ (MAUs) following the healthcare decentralization and coordination reform in 2012.”
The aim was to provide well-integrated services more adapted to individual users. Findings show that the reformed healthcare service is better for older patients who need close follow-up. Martinussen said, “We’ve found that introducing these medical units is associated with both lower mortality and fewer readmissions.”
However, this finding only applies to the oldest patients. The connection is also significantly stronger if the municipal acute units are well-staffed by medical professionals. This type of intermediate health service is thus associated with lower mortality rates for the elderly. It might indicate that the healthcare services within the municipalities have improved since MAUs were introduced.
“Our findings are a strong indication that MAUs have worked as intended. Health services for the elderly might have improved by moving some treatment from the hospitals to where people live. But this should be followed up by further research,” says Martinussen.