Assessing the Impact of an Integrated Community Care Program on Unplanned Hospital and Emergency Department Representations: Interrupted Time Series Analysis.

The study used retrospective administrative data and an observational interrupted time series design, so it cannot prove that the amalgamation caused the observed changes. There was no concurrent control group because the change was service-wide, so other time-related factors could have influenced the trends. The patients enrolled before and after were not clinically identical: the post-amalgamation group was older and had lower comorbidity scores. The program combined PAC, RIR and HARP and included medical, nursing and specialised health services, so the contribution of any single component cannot be separated. The measured outcomes were unplanned readmission and ED-only re-presentation; quality of life and other patient-reported outcomes were not assessed. The findings come from one public health service in Victoria, Australia, so they may not apply to other health systems.

Do not conclude that merging PAC, RIR and HARP into Community Care reduced unplanned hospital or emergency department returns. The study found no statistically significant change in the main readmission or ED-only re-presentation trends, and the contribution of any single service component cannot be separated.