Effectiveness of a Hospital-at-Home Integrated Care Program as Alternative Resource for Medical Crises Care in Older Adults With Complex Chronic Conditions

Mas, Miquel Àngel; Santaeugènia, Sebastià; Tarazona-Santabalbina, Francisco José; Gámez, Sara; Inzitari, Marco

doi:10.1016/j.jamda.2018.06.013

“…Our findings show that in 2014, in Catalonia, the results for readmission, mortality, and mean length of stay for the two HaH modalities, in spite of their heterogeneous development, could be similar to those observed in previous studies throughout the world [5][6][7]19]. In addition, irrespective of the modality, it was observed that comorbidity and type of hospital are related to readmission and mean length of stay whilst the patient's age is linked to mortality.…”

Section: Discussionsupporting

confidence: 86%

“…Previous studies comparing HaH and CH [5,13,[20][21][22] have reported that home care can have similar results to CH and would save both human and economic resources [23][24][25][26]. In this sense, both the results obtained and the available evidence suggest that, provided the patient's indication permit it and new causal research confirm them, HaH treatment could be a suitable, effective, and perhaps efficient alternative to CH [10,19,24,27].…”

Section: Discussionmentioning

confidence: 80%

Differences in results and related factors between Hospital-at-Home modalities in Catalonia: a cross sectional study

Torre

¹

,

Zioga

²

,

Macorigh

³

et al. 2020

Preprint

0

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Background Hospital-at-home (HaH) is a healthcare modality that provides active treatment by healthcare staff in the patient’s home for a condition that would otherwise require hospitalization. Previous studies have described two basic types of HaH: hospital admission avoidance and early discharge The aims of this study were: To describe the characteristics of different types of hospital-at-home (HaH) contacts; to assess readmission, mortality, and mean length of stay for each HaH modality; and to examine which factors could be related to these results. Methods A cross-sectional study based on data from all 2014 HaH contacts from Catalonia was designed. The following HaH modalities were considered: admission avoidance (n=7,214; 75.1%) and early discharge (n=2,387; 24.9%). The main outcome indicators were readmission, mortality, and mean length of stay (days). Contact characteristics were compared at bivariable level and indicators were calculated for each HaH modality. Multivariable General linear models were fitted to assess the association between explanatory factors and outcomes. Results Differences in contact characteristics between HaH modalities were observed at bivariable level. In the hospital avoidance modality there were 8.3% readmissions, 0.9% mortality, and a mean length of stay (SD) of 9.6 (10.6) days. In the early discharge one, these figures were 7.9%, 0.5%, and 9.8 (11.1), respectively. In both modalities, readmission and mean length of stay were related to comorbidity and type of hospital, and mortality with age. Conclusions The results show that the HaH results in Catalonia are acceptable and similar to those observed in other contexts. The factors related to these results could help improve the effectiveness and efficiency of the different HaH modalities.

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“…Our findings show that in 2014, in Catalonia, the results for readmission, mortality, and mean length of stay for the two HaH modalities, in spite of their heterogeneous development, could be similar to those observed in previous studies throughout the world [5][6][7]21]. In addition, irrespective of the modality, it was observed that comorbidity and the type of hospital are related to readmission and mean length of stay whilst the patient's age is linked to mortality.…”

Section: Discussionsupporting

confidence: 86%

Differences in Results and Related Factors between Hospital-At-Home Modalities in Catalonia: A Cross-Sectional Study

Torre

¹

,

Zioga

²

,

Macorigh

³

et al. 2020

JCM

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Hospital-at-home (HaH) is a healthcare modality that provides active treatment by healthcare staff in the patient’s home for a condition that would otherwise require hospitalization. The aims were to describe the characteristics of different types of hospital-at-home (HaH), assess their results, and examine which factors could be related to these results. A cross-sectional study based on data from all 2014 HaH contacts from Catalonia was designed. The following HaH modalities were considered—admission avoidance (n = 7214; 75.1%) and early assisted discharge (n = 2387; 24.9%). The main outcome indicators were readmission, mortality, and length of stay (days). Multivariable models were fitted to assess the association between explanatory factors and outcomes. Hospital admission avoidance is a scheme in which, instead of being admitted to acute care hospitals, patients are directly treated in their own homes. Early assisted discharge is a scheme in which hospital in-care patients continue their treatment at home. In the hospital avoidance modality, there were 8.3% readmissions, 0.9% mortality, and a mean length of stay (SD) of 9.6 (10.6) days. In the early assisted discharge modality, these figures were 7.9%, 0.5%, and 9.8 (11.1), respectively. In both modalities, readmission and mean length of stay were related to comorbidity and type of hospital, and mortality with age. The results of HaH in Catalonia are similar to those observed in other contexts. The factors related to these results identified might help to improve the effectiveness and efficiency of the different HaH modalities.

show abstract

“…Our findings show that in 2014, in Catalonia, the results for readmission, mortality, and mean length of stay for the two HaH modalities, in spite of their heterogeneous development, are similar to those observed in previous studies throughout the world [4][5][6]16]. In addition, irrespective of the modality, it was observed that comorbidity and type of hospital are closely related to readmission and mean length of stay whilst the patient's age is strongly linked to mortality.…”

Section: Discussionsupporting

confidence: 86%

“…In this sense, both the results obtained and the available evidence suggest that, provided the patient's indication permit it, HaH treatment could be a suitable, effective, and possibly efficient alternative to CH [8,16,21].…”

Section: Discussionmentioning

confidence: 99%

Differences in results and related factors between Hospital-at-Home modalities in Catalonia: a cross sectional study

Torre

¹

,

Zioga

²

,

Macorigh

³

et al. 2019

Preprint

0

View full text Add to dashboard Cite

Background Hospital-at-home (HaH) is a healthcare modality that provides active treatment by healthcare staff in the patient’s home for a condition that would otherwise require hospitalization. Previous studies have described two basic types of HaH: hospital admission avoidance and early discharge The aims of this study were: To describe the characteristics of different types of hospital-at-home (HaH) contacts; to assess readmission, mortality, and mean length of stay for each HaH modality; and to examine which factors could be related to these results. Methods A cross-sectional study based on data from all 2014 HaH contacts from Catalonia was designed. The following HaH modalities were considered: admission avoidance (n=7,214; 75.1%) and early discharge (n=2,387; 24.9%). The main outcome indicators were readmission, mortality, and mean length of stay (days). Contact characteristics were compared at bivariable level and indicators were calculated for each HaH modality. Multivariable General linear models were fitted to assess the association between explanatory factors and outcomes. Results Differences in contact characteristics between HaH modalities were observed at bivariable level. In the hospital avoidance modality there were 8.3% readmissions, 0.9% mortality, and a mean length of stay (SD) of 9.6 (10.6) days. In the early discharge one, these figures were 7.9%, 0.5%, and 9.8 (11.1), respectively. In both modalities, readmission and mean length of stay were related to comorbidity and type of hospital, and mortality with age. Conclusions The results show that the HaH results in Catalonia are acceptable and similar to those observed in other contexts. The factors related to these results could help improve the effectiveness and efficiency of the different HaH modalities.

show abstract

Effectiveness of a Hospital-at-Home Integrated Care Program as Alternative Resource for Medical Crises Care in Older Adults With Complex Chronic Conditions

Cited by 37 publications

References 26 publications

Differences in results and related factors between Hospital-at-Home modalities in Catalonia: a cross sectional study

Differences in results and related factors between Hospital-at-Home modalities in Catalonia: a cross sectional study

Differences in Results and Related Factors between Hospital-At-Home Modalities in Catalonia: A Cross-Sectional Study

Differences in results and related factors between Hospital-at-Home modalities in Catalonia: a cross sectional study

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