Association between advance care planning combined with super-enhanced transitional care and outcomes of facility death and bed availability in a Japanese geriatric health services facility

Objective

Advance care planning (ACP) is vital for long-term care. However, its operational effects remain unclear. We implemented "ACPSET", integrating ACP with super-enhanced transitional care (SET). Given the limited evidence on integrated care models, we hypothesized that ACPSET would improve the predictability of facility deaths, enable efficient bed use, and reduce monthly average number of vacant beds. This study evaluated ACP's impact on facility deaths and ACPSET-related bed availability. Materials and Methods: In this retrospective cohort study, we compared facility deaths between residents with (n=46) and without (n=842) ACP using propensity score matching (PSM; n=45/group). Welch's t-test and interrupted time-series analysis (ITSA) were used to compare the natural logarithm of monthly average number of vacant beds between the SET preparation period (October 1, 2021 to March 31, 2023) and the ACPSET implementation period (April 1, 2023 to September 30, 2024). Multiple regression analysis was used to examine the factors associated with vacant beds, including hospital admissions and facility deaths.