Hospital-at-home for COPD: A retrospective comparison with brick-and-mortar settings

Area of Science:

• Health Services Research
• Pulmonology
• Geriatrics

Background:

• The Acute Hospital Care at Home (AHCaH) initiative has expanded access to Hospital-at-Home (HaH) care.
• Differences in care delivery and outcomes between AHCaH-compliant HaH and traditional brick-and-mortar (BaM) inpatient settings for chronic obstructive pulmonary disease (COPD) are not well understood.

Purpose of the Study:

• To compare the management and outcomes of adults hospitalized with COPD in HaH versus BaM settings.
• To evaluate the effectiveness of AHCaH-compliant HaH programs for COPD patients.

Main Methods:

• Retrospective cohort study analyzing electronic health record (EHR) data from 2022.
• Compared 178 adults treated in HaH with 119 adults treated in BaM who were eligible for HaH.
• Analyzed orders for supplemental oxygen, bronchodilators, and 30-day acute care-free days alive.

Main Results:

• HaH patients had a higher likelihood of receiving supplemental oxygen (RR: 1.04) and bronchodilators (RR: 1.12) compared to BaM patients.
• HaH patients experienced more 30-day acute care-free days alive (MR: 1.04).
• Findings suggest comparable or enhanced guideline-directed therapy in HaH settings.

Conclusions:

• AHCaH-compliant HaH care appears to provide similar or improved guideline-directed therapy and outcomes for COPD patients.
• Hospital-at-Home care models show promise for managing common, costly hospital conditions like COPD.
• Further research into HaH care delivery for various conditions is warranted.