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Hospital in the home: a randomised controlled trial
G A Caplan1, J A Ward, N J Brennan
1Post Acute Care Services, Prince of Wales Hospital, Sydney, NSW. g.caplan@unsw.edu.au
The Medical Journal of Australia
|March 17, 1999
Summary
Hospital-at-home care is a safe alternative to hospitalization for acute illness, especially for older adults. This approach leads to higher patient and carer satisfaction and fewer geriatric complications.
Area of Science:
- Geriatric Medicine
- Health Services Research
- Acute Care
Background:
- Hospitalization for acute illness can lead to adverse outcomes in older adults, including geriatric complications.
- Alternative care models are needed to improve patient safety and satisfaction.
Purpose of the Study:
- To compare the safety, effectiveness, and patient/carer satisfaction of hospital-at-home (HIH) care versus traditional hospital admission for acute illness.
Main Methods:
- A randomized controlled trial was conducted involving 100 patients requiring hospital admission.
- Patients were randomly assigned to either a hospital-at-home service or inpatient hospital care.
- Outcomes assessed included geriatric complications, patient/carer satisfaction, adverse events, and mortality.
Main Results:
- HIH treatment resulted in significantly lower rates of confusion, urinary complications, and bowel complications compared to hospital admission.
- No significant differences were observed in adverse events or mortality between the two groups.
- Patient and carer satisfaction was significantly higher in the hospital-at-home group.
Conclusions:
- Hospital-at-home care is a safe and effective alternative to hospitalization for selected patients with acute conditions.
- This model of care may be particularly beneficial for older patients, offering improved satisfaction and reduced complications.