Intermediate care in the Netherlands: differences in patient characteristics and experiences with the implementation of an integrated care pathway

Background: Short-term residential care (STRC) is an intermediate care model in the Netherlands that provides temporary inpatient care for community-dwelling older adults who experience a sudden health or functionality decline. Variations in admission criteria, treatment in STRC and admission capacity across regions leads to lack of insights into population characteristics but also in standardization of treatment.

Approach: Together with professionals of nine STRC departments in the Netherlands, a patient-centered integrated care pathway for STRC was developed. To provide insight into patient characteristics within STRC and to examine the effect of implementing the new care pathway, a process and effect evaluation is performed. To assess the effects, a prospective cohort study will be performed. Across nine STRC departments in the Netherlands data is collected on age, gender, informal care, functional status (measured with Barthel Index), quality of life (measured with EQ-5D), quantity of received care and treatment, set and achieved recovery goals and discharge location. To assess whether or not STRC departments implemented the patient-centered care pathway, data was collected on adherence to planned implementation, perceived feasibility, factors that either facilitate or hinder the care pathway and the experiences of both clients and healthcare providers regarding the care provided.

Results: Currently (October 2024) the baseline measurement is ongoing. Results of patient characteristics on the baseline measurement will be presented during the conference, as well as differences between organizations and regions. Next to this, results of the process evaluation will be presented which will be performed between January – July 2025. These results will provide insight into the feasibility of the new STRC care pathway, identifying the facilitating and hindering factors as well as experiences of clients and healthcare providers with the care provided using the new STRC care pathway.

Implications: This study sheds light on the expected variation of patients admitted to STRC facilities, both between regions and organizations, as well as recommendations on the feasibility and experiences of clients and healthcare providers with the new STRC care pathway. It is expected that implementation of the pathway will lead to a decrease in variations in admission criteria and treatment provided in STRC and will better suit the needs of the patients admitted.