Gloucester hospital-at-home: a randomized controlled trial

Hospital-at-Home schemes have been claimed to hasten the discharge of elderly orthopaedic patients, and are becoming increasingly popular with health service managers. In an attempt to measure the benefits of such a scheme when applied to elderly medical patients, we prospectively randomized 60 consecutive referrals of patients approaching discharge either to the Hospital-at-Home (HAH) rehabilitation team, or to conventional discharge (CD) preparation and domiciliary support. Patients allocated to HAH were discharged on average 5 days earlier than CD, while 64% of each group remained at home during 6 months follow-up. Improvements in independence were modest, and similar in the two groups, though a trend favoured HAH.