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Randomised controlled trial comparing an acute paediatric hospital at home scheme with conventional hospital care
S A Sartain1, M J Maxwell, P J Todd
1Wirral Services for Child Health.
Insights
Hospital at Home care is a clinically effective alternative for acute paediatric illnesses, with no significant difference in readmission rates. Most parents and children preferred home-based care, despite a slightly longer care duration.
Area of Science:
- Pediatric healthcare research
- Comparative effectiveness studies
- Home-based care models
Background:
- Hospital at Home (HaH) services offer an alternative to traditional inpatient care for children.
- Assessing the clinical effectiveness and patient satisfaction of HaH is crucial for healthcare planning.
Purpose of the Study:
- To compare the clinical effectiveness of a paediatric Hospital at Home service against conventional hospital care.
- To evaluate readmission rates, length of care, and patient/carer satisfaction.
Main Methods:
- A randomized controlled trial involving 399 children with breathing difficulty, diarrhea/vomiting, or fever.
- Participants were assigned to either Hospital at Home or inpatient paediatric care.
- Outcomes included 3-month readmission rates, length of stay, and patient/carer satisfaction.
Main Results:
- No significant difference in clinical effectiveness was observed between Hospital at Home and inpatient care.
- The Hospital at Home group experienced a one-day longer length of care.
- A strong preference for home care was reported by most parents and children.
Conclusions:
- Hospital at Home is a clinically acceptable care option for acute paediatric conditions.
- Readmission rates did not indicate an advantage for Hospital at Home in terms of parental coping.
- Patient and carer preference strongly favors the Hospital at Home model.
Aims:
To assess the clinical effectiveness of a paediatric hospital at home service compared to conventional hospital care.
Methods:
A total of 399 children suffering from breathing difficulty (n = 202), diarrhoea and vomiting (n = 125), or fever (n = 72) were randomised to Hospital at Home or in-patient paediatric care. Main outcome measures were: comparative clinical effectiveness as measured by readmission rate within three months (used as a proxy for parental coping with illness); and length of stay/care and comparative satisfaction of both patients and carers.
Results:
Clinical effectiveness of both services was not significantly different. Length of care was one day longer in the Hospital at Home group; however, most parents and children preferred home care.
Conclusions:
Hospital at Home is a clinically acceptable form of care for these groups of acute paediatric illness. Readmission rates within three months failed to show any advantage in terms of parental coping. Parents and patients expressed a strong preference for hospital at home.
