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Updated: Jul 1, 2025

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

Published on: September 30, 2020

Admission avoidance hospital at home.

Kate Edgar¹, Steve Iliffe², Helen A Doll³

¹Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK.

The Cochrane Database of Systematic Reviews

|March 4, 2024

Summary

Hospital at home care offers an alternative to inpatient treatment, potentially reducing hospital stays and costs. While it may not significantly alter health outcomes, it can improve patient satisfaction and decrease moves to residential care.

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Area of Science:

Healthcare delivery models
Geriatric medicine
Health services research

Background:

Hospital at home provides acute inpatient care within a patient's residence.
This is the fourth update of a Cochrane review examining this care model.

Purpose of the Study:

To evaluate the effectiveness and cost of admission avoidance hospital at home versus traditional inpatient hospital care.

Main Methods:

Systematic review and meta-analysis of 20 randomized controlled trials (3100 participants).
Included studies compared hospital at home with acute inpatient care for adults.
GRADE methodology was used to assess evidence certainty.

Main Results:

Hospital at home showed little to no difference in mortality or hospital readmissions.
It likely reduces the likelihood of patients moving to residential care.
Average hospital length of stay was reduced, with potential cost savings for health services and society.

Conclusions:

Admission avoidance hospital at home may be an effective alternative for selected older patients.
It likely offers comparable health outcomes, improved satisfaction, and reduced costs.
The model may decrease the need for long-term residential care placement.