Home Hospitalization

Maaravi, Yoram; Cohen, Aaron M.; Hammerman‐Rozenberg, Robert; Stessman, Jochanan

doi:10.1016/s1525-8610(04)70424-7

Cited by 8 publications

(5 citation statements)

References 23 publications

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“…PMV care in Jerusalem is provided either in a single specialized LTAC (Chronic Ventilator-Dependent Division, Herzog Medical Center, Jerusalem), or at home, cared for by the Jerusalem Home Hospital. 24 , 25 , 26 , 27 , 28 The decision concerning site of care depends on the patient's and/or custodian's agreement, sufficient informal/formal home care, and medical condition. At the time of the study, there were 120 beds in the LTAC available for adult PMV patients, of which 76 beds were occupied by PMV patients of the Clalit Health Fund.…”

Section: Methodsmentioning

confidence: 99%

Prolonged Mechanical Ventilation: Symptomatology, Well-Being, and Attitudes to Life

Jacobs

Marcus

Stessman

2021

Journal of the American Medical Directors Association

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Objective Although prolonged mechanical ventilation (PMV) is increasingly common, little is known concerning patient symptom burden or attitudes toward PMV. This study aims to describe the mood, well-being, distressing symptoms, and attitudes toward prolonged ventilation among PMV patients treated either at home or long-term acute care (LTAC). Design An observational study. Setting and Participants 62 communicative participants treated with PMV, aged ≥18 years, insurees of a single HMO, treated at home hospital or LTAC specializing in ventilation in Jerusalem. Measures Sociodemographic characteristics; chronic conditions; functional status; symptom burden measured by revised Edmonton Symptomatic Assessment System (r-ESAS); attitudes toward PVM. Results Participants were aged 61.7 ± 20.7 years, commonly suffered progressive neuromuscular disease (43.5%) or chronic lung disease (29%), were functionally dependent, treated at home (64.5%) or LTAC (35.5%), and had a mean PMV duration of 36.6 months (interquartile range 10.8-114.1). The 5-item, short Geriatric Depression Scale identified depression among 38% of participants, and was less at home vs LTAC (34% vs 44%, P < .001). Mean revised Edmonton Symptom Assessment System score was 24.5 ± 14.8 (maximum severity = 100), and participants reported severe or distressing symptoms for tiredness (27%/20%), pain (10%/25%), anxiety (16%/14%), depression (9%/21%), drowsiness (12%/17%), shortness of breath (9%/15%), poor appetite (7%/9%), and nausea (0%/10%). Impaired general well-being was reported as severe, moderate, mild, or none among 15%, 40%, 30%, and 15%, respectively. Only 1 patient had advance directives concerning ventilation prior to intubation, and when asked if they had to choose again today, 85% of patients would again opt for ventilation. Conclusions and Implications Few PMV patients reported distressing symptoms, and 85% would choose ventilation if asked again. These findings might be useful in clinical practice to assist in decision making concerning prolonged ventilation.

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Section: Methodsmentioning

confidence: 99%

Prolonged Mechanical Ventilation: Symptomatology, Well-Being, and Attitudes to Life

Jacobs

Marcus

Stessman

2021

Journal of the American Medical Directors Association

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“…The growing demand for quality medical services and an increase in the prevalence of chronic diseases in increasingly older populations, with the consequent deficit of hospital beds, is leading to change the traditional strategies in which the hospital is the center of medical care (9,11).…”

Section: Discussionmentioning

confidence: 99%

“…All without being inferior to the traditional hospital care model (8,9). Day care hospital polyvalent units allow the application of medications at home as an alternative to reduce the need for traditional hospital care (10); in addition, they provide specialized care and targeted treatments with adequate quality standards that fulfill the expectations of patients and their families, especially those who require frequent hospitalizations for decompensated chronic diseases (11,12).…”

Section: Introductionmentioning

confidence: 99%

Follow up to a multipurpose hospital day care model in Medellin city

Coronado

Ariza²,

Betancur³

et al. 2018

CES Med.

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“…A hospitalização domiciliária (HD) é uma alternativa ao internamento convencional que se caracteriza pela prestação de cuidados de saúde de nível hospitalar no domicílio. 1,2 Este internamento tem complexidade, intensidade e duração equivalentes ao internamento convencional. Os doentes elegíveis para a HD são aqueles que cumprem os requisitos nas seguintes categorias 2-6 :…”

Section: Introductionunclassified

“…• Melhorar a satisfação dos doentes e cuidadores em relação ao sistema de saúde, pela melhor perceção da doença pela família e pelo maior conforto do doente 1,6,12 ;…”

Section: Introductionunclassified

A Hospitalização Domiciliária na Pandemia COVID-19

Azevedo

2020

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A hospitalização domiciliária tem vindo a implementar-se no sistema de saúde português como um modelo de assistência de nível hospitalar no domicílio. É uma alternativa ao internamento convencional, para doentes agudos ou crónicos agudizados, sendo a admissão nesta tipologia de internamento voluntária. Devem estar garantidos os critérios de admissão, que passam essencialmente pela estabilidade clínica com comorbilidades controláveis no domicílio, presença de cuidador e domicílio com boas condições de higiene e segurança, e domicílio na área de influência da unidade hospitalar de referência. As vantagens da hospitalização domiciliária parecem ser evidentes, nomeadamente no que toca à significativa redução das infeções nosocomiais, quedas e episódios de síndroma confusional aguda. No atual contexto da pandemia COVID-19, a hospitalização domiciliária pode ser parte da solução de resposta do sistema de saúde, não só pelo aumento da capacidade de internamento domiciliário de doentes sem infeção por SARS-CoV-2 mas também, cumprindo todas as recomendações de segurança, ser uma possibilidade de internamento para doentes com infeção por SARS-CoV-2 após, pelo menos, 7 dias de internamento hospitalar convencional com estabilidade clínica, possibilidade de isolamento e cuidador não portador de condição de saúde vulnerável. A equipa de saúde da hospitalização domiciliária assume aqui um papel-chave na educação e promoção da saúde, proporcionando aprendizagens no que toca às medidas de isolamento, higiene das mãos e etiqueta respiratória. Cumpridos os critérios de admissão, a hospitalização domiciliária é uma tipologia de internamento que permite atingir a eficiência sem prejuízo da segurança do doente.

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Home Hospitalization

Abstract: For 8 years, HH in Jerusalem has provided intensive home care with high levels of patient and family satisfaction.

Cited by 8 publications

References 23 publications

Prolonged Mechanical Ventilation: Symptomatology, Well-Being, and Attitudes to Life

Prolonged Mechanical Ventilation: Symptomatology, Well-Being, and Attitudes to Life

Follow up to a multipurpose hospital day care model in Medellin city

A Hospitalização Domiciliária na Pandemia COVID-19

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