Hospital at Home: Feasibility and Outcomes of a Program To Provide Hospital-Level Care at Home for Acutely Ill Older Patients

Leff, Bruce; Burton, Lynda; Mader, Scott L.; Naughton, Bruce J.; Burl, Jeffrey B.; Inouye, Sharon K.; Greenough, William B.; Guido, Susan; Langston, Christopher A.; Frick, Kevin D.; Steinwachs, Donald M.; Burton, John

doi:10.7326/0003-4819-143-11-200512060-00008

Cited by 396 publications

(337 citation statements)

References 38 publications

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“…10 Many improvements in health outcomes have been demonstrated with HITH studies. [11][12][13][14][15][16] Introduced into Australia in 1994, 17 it is rarely acknowledged that most of these important initiatives were preceded by extensive research and implementation of intensive home-based models of mental health care, e.g. assertive mobile 7-day and night community-based mental health teams.…”

Section: Persistent Long-term and Recurrent Conditionsmentioning

confidence: 99%

The future of community-centred health services in Australia: lessons from the mental health sector

Rosen

Gurr

Fanning

2010

Aust. Health Review

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Abstract* It is apparent that hospital-dominated health care produces limited health outcomes and is an unsustainable health care system strategy. * Community-centred health care has been demonstrated to be a more cost-efficient and cost-effective alternative to hospitalcentred care, particularly for prevention and care of persistent, long-term or recurrent conditions. Nevertheless, hospitalcentred services continue to dominate health care services in Australia, and some state governments have presided over a retreat from, or even dismantling of, community health services. * The reasons for these trends are explored. * The future of community health services in Australia is uncertain, and in some states under serious threat. We consider lessons from the partial dismantling of Australian community mental health services, despite a growing body of Australian and international studies finding in their favour. * Community-centred health services should be reconceptualised and resourced as the centre of gravity of local, effective and affordable health care services for Australia. A growing international expert consensus suggests that such communitycentred health services should be placed in the centre of their communities, closely linked or collocated where possible with primary health care, and functionally integrated with their respective hospital-based services.What is known about the topic? Community-centred health care has been widely demonstrated to be a more cost-efficient and cost-effective alternative to hospital-centred care, particularly for prevention and care of persistent, long-term or recurrent conditions, e.g. in mental health service systems. A growing international expert consensus suggests that such communitycentred health services should be placed in the centre of their communities, closely linked or collocated where possible with primary health care, and functionally integrated with their respective hospital-based services. What does this paper add? Despite this global consensus, hospital-centred services continue to dominate health care services in Australia, and some state governments have presided over a retreat from, or even dismantling of, community health services. The reasons for these trends and possible solutions are explored. What are the implications for practitioners? Unless this trend is reversed, the loss of convenient public access to community health services at shopping and transport hubs and the consequent compromising of intensive home-based clinical care, will lead to a deterioration of preventative interventions and the health care of long-term conditions, contrary to international studies and reviews.

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Section: Persistent Long-term and Recurrent Conditionsmentioning

confidence: 99%

The future of community-centred health services in Australia: lessons from the mental health sector

Rosen

Gurr

Fanning

2010

Aust. Health Review

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“…By identifying an average of 1.7 new problems compared to a thorough geriatric assessment, 3 house calls may prevent future problems and improve quality of care. Improved quality, affordability, and patient experience have been shown in the "hospital-at-home" program, 4,5 where patients requiring hospitalization for problems such as pneumonia, congestive heart failure, chronic obstructive pulmonary disease, or cellulitis are managed at home with daily physician visits, intensive nursing coverage, and other services. More than 9 house calls to a patient have been shown to reduce nursing home admissions, functional decline, and mortality.…”

Section: Irene Hamrick MDmentioning

confidence: 99%

More House Calls by Fewer Physicians

Hamrick

2012

The Journal of the American Board of Family Medicine

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“…Established models for delivering hospital-level care in the home setting exist internationally, including United States, Canada, Israel, Australia, New Zeland, Spain, United Kingdom, Italy, France (Leff et al, 2005;Lemelin et al, 2007;Stessman et al, 1996;Caplan et al, 1999;Montalto, 2002;Richards et al, 2005;Cerrillo -Rodriguez et al, 2009;Pérez-Lopez et al, 2008;Kalra et al, 2008;Wilson et al, 1999;Myles et al, 1996;Aimonino Ricauda et al, 2008).…”

Section: Current Knowledge On Home Care For Copd Exacerbationsmentioning

confidence: 99%

Hospital at Home for Elderly Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Nicoletta¹,

Tibaldi²,

Bertone³

et al. 2012

Chronic Obstructive Pulmonary Disease - Current Concepts and Practice

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Hospital at Home: Feasibility and Outcomes of a Program To Provide Hospital-Level Care at Home for Acutely Ill Older Patients

Abstract: The hospital-at-home care model is feasible, safe, and efficacious for certain older patients with selected acute medical illnesses who require acute hospital-level care.

Cited by 396 publications

References 38 publications

The future of community-centred health services in Australia: lessons from the mental health sector

The future of community-centred health services in Australia: lessons from the mental health sector

More House Calls by Fewer Physicians

Hospital at Home for Elderly Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

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