3754 EAGLEcare: reducing healthcare utilisation for nursing home residents at the end of life

Abstract Introduction Older people living in Nursing Homes (NH) are often admitted to Acute Hospitals (AH) towards their end-of-life (EOL) due to the limited capacity to manage exacerbations and symptoms within NHs. The EAGLEcare (Enhancing Advance care planning, Geriatric and End-of-Life care in NHs in the East) Programme was set up to improve in-NH care and to reduce avoidable AH admissions and their unintended consequences. Methods A system of proactive case-finding for residents with specific and general indicators of advanced life-limiting illnesses was developed in collaboration with NH partners, to enable early symptom recognition and timely response(s), supported by NH General Practitioners (GPs) and an interdisciplinary team from the AH, with out of hours coverage by a collaborating home palliative care service. We retrospectively studied a cohort of residents who passed away between January 2019 and December 2023 from five NHs during their final 6 months of life. Parameters including hospital admissions, emergency department (ED) visits, length of stay (LOS), and specialist outpatient clinic (SOC) visits were compared between EAGLEcare-enrolled and non-enrolled residents. Propensity score matching (1:5 ratio) was used to balance baseline characteristics, and negative binomial regression was employed to assess programme impact. Results After matching, 369 enrolled and 393 non-enrolled residents were analysed. Residents enrolled in the EAGLEcare Programme had significantly lower rates of hospital admissions (aIRR = 0.86, 95% CI: 0.77–0.97, p = 0.016), ED visits (aIRR = 0.82, 95% CI: 0.73–0.93, p = 0.001), and shorter LOS (aIRR = 0.82, 95% CI: 0.69–0.97, p = 0.024). However, SOC visit rates remained similar between groups. Conclusion(s) The EAGLEcare Programme effectively reduced hospitalizations and ED visits among NH residents at the EOL, supporting the need for integrated care models. Expanding such initiatives could improve EOL care, reduce healthcare burden, and enhance patient outcomes.