Admission avoidance hospital at home

Abstract

Background Admission avoidance hospital at home provides active treatment by healthcare professionals in the patient's home for a condition that otherwise would require acute hospital inpatient care, and always for a limited time period. This is the third update of the original review. Objectives To determine the effectiveness and cost of managing patients with admission avoidance hospital at home compared with inpatient hospital care. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, two other databases, and two trials registers on 2 March 2016. We checked the reference lists of eligible articles. We sought unpublished studies by contacting providers and researchers who were known to be involved in the field. Selection criteria Randomised controlled trials recruiting participants aged 18 years and over. Studies comparing admission avoidance hospital at home with acute hospital inpatient care. Data collection and analysis We followed the standard methodological procedures expected by Cochrane and the Effective Practice and Organisation of Care (EPOC) Group. We performed meta-analysis for trials that compared similar interventions and reported comparable outcomes with sufficient data, requested individual patient data from trialists, and relied on published data when this was not available. We used the GRADE approach to assess the certainty of the body of evidence for the most important outcomes.

Efficacy of hospital in the home services providing care for patients admitted from emergency departments

“…6 Hospital in the home services have been defined as those that provide 'an alternative to admission to a hospital or an opportunity for earlier relocation to the home than would otherwise be possible.' 8 An important distinction to make between HiTH services is between those that completely substitute the inpatient stay (admission-avoidance HiTH) 9 and those that facilitate a reduction in the inpatient LOS (early-discharge HiTH). Rather, HiTH services deliver a range of interventions (intravenous antibiotics, antivirals, antifungals, fluids, blood products, inotropes, steroids, and enzyme replacement agents), to a range of patient cohorts (neonatal, paediatric, adult and elderly), requiring treatment for a range of conditions (community-acquired acute infections; hospital-acquired, multi-resistant and complicated infections; acute venous thromboembolism; perioperative anticoagulation; chemotherapy and other cancer care; heart failure management, wound management and mental health care).…”

Por qué sigo creyendo en el hospital a domicilio

“…Hay que resaltar que el HAD ha sido una de las innovaciones más estudiadas en el marco de la atención sanitaria: en la última actualización de la revisión Cochrane sobre los modelos de evitación de ingresos, son 16 los ensayos clínicos aleatorizados (ECA) analizados (2).…”

Implementation of Home Hospitalization and Early Discharge as an Integrated Care Service: A Ten Years Pragmatic Assessment

“…But, the most recent Cochrane review [723] concludes that Home Hospitalization/Early Discharge is indicated for selected groups of elderly patients adding a degree of imprecision to the results for the main outcomes. Moreover, efficient care coordination after Home Hospitalization/Early Discharge is relevant, but it is often an unmet need.…”

“…It is of note, however, that recent reports [23456] seem to overcome those limitations by demonstrating maturity and health value generation of Home Hospitalization/Early Discharge. Likewise, the 2016 Cochrane review [7] concludes that Home Hospitalization may constitute an effective alternative to inpatient care for a selected group of elderly patients requiring hospital admission.…”