Transition Care for Older People

Introduction
Transitional arrangements for older people are an increasingly important element of the health service delivery system. The Australian government is developing substantial programs that focus on management of the interfaces between hospitals, and community, and residential care. Transition Care programs attempt to integrate aged care and health services to provide coordinated services to frail older people.

Transition Care
The Transition Care Program provides goal oriented, time limited and therapy focused care to help older people at the conclusion of a hospital stay. It is an Australian Government Program, that is jointly funded and administered by state health departments. Its aim is to assist older people in transition between hospital (or home) and residential aged care. The new Australian Government has given a commitment to expand transition care markedly.

Research Program
In 2006 a NH&MRC funded a group of researchers from New South Wales, South Australia and Queensland to address some of the key questions associated with transition services and service integration. The NSW group is researching the effect of Transition Care on frailty in the Frailty Intervention Trial. The QLD researchers are investigating different methods of delivering Transition Care. The SA team is considering policy implications.

Closing the Care Gaps

Contact Information: Dr Liz Gill Transitional Care Research Program Manager. Email: medicine.tie@sydney.edu.au

Research Institutions
The University of Sydney

Flinders University

The University of Queensland

Funding
Funded by a Strategic Initiative Grant awarded by the National Health and Medical Research Council