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Hospital-Level Care at Home for Patients With Acute Respiratory Disease: A Descriptive Analysis
Carme Hernandez1, Ann-Marcia C Tukpah2, Henry M Mitchell3
1Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA; Home Hospitalization, Medical and Nursing Direction, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERES, Barcelona, Spain.
Chest
|November 13, 2022
Summary
Home hospital care is safe and effective for acute respiratory illness, matching outcomes of other conditions. This approach can expand healthcare capacity and the complexity of care delivered at home.
Area of Science:
- Pulmonary Medicine
- Healthcare Management
- Health Services Research
Background:
- Home hospital (HH) care provides hospital-level acute care at home.
- Evidence suggests HH care offers similar or better outcomes than traditional hospital settings.
- Outcomes for respiratory disease patients in US HH care have not been previously evaluated.
Purpose of the Study:
- To determine if outcomes differ for patients admitted to HH care with acute respiratory illness compared to those with other acute general medical conditions.
Main Methods:
- Retrospective analysis of prospectively collected data from 2017-2021.
- Compared patients with respiratory disease (asthma, COPD, pneumonia) to other HH care patients.
- Assessed acute and postacute healthcare utilization and safety.
Main Results:
- 24% of 1,031 HH care patients had respiratory disease; they were similar demographically but more often active smokers.
- Respiratory patients used less healthcare resources: shorter length of stay, fewer lab orders, less IV medication, and fewer specialist consultations.
- High completion rate (96%) with no mortality during HH care for respiratory patients; 30-day post-discharge outcomes were similar across groups.
Conclusions:
- Home hospital care is a safe and effective alternative for acute respiratory conditions.
- Scaling HH care can significantly increase healthcare capacity and allow for more complex treatments at home.
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