A recent systematic review examined the alternatives to hospital admission for older patients at risk of unplanned hospitalisation. The broad categories of interventions considered were (i) improved use of paramedic / emergency care practitioners, (ii) interventions based in emergency departments, (iii) community hospitals and (iv) hospital-at-home services.
While detailed information about cost-effectiveness and patient acceptability is lacking at present, the authors consider that the results so far indicate many of the options available are safe and probably would reduce avoidable use of limited resources / acute care capacity.
Huntley, AL. Chalder, M. Shaw, ARG. [et al] (2017). A systematic review to identify and assess the effectiveness of alternatives for people over the age of 65 who are at risk of potentially avoidable hospital admission. BMJ Open. August 1st 2017; 7(7): e016236.