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“Hospital at home” care was generally as effective as routine hospital care for older adults

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Question Is “hospital at home” (HaH) care as effective and cost effective as inpatient hospital care for older adults?

Design

Randomised controlled trial (RCT) with 3 months follow up.

Setting

A district general hospital and its catchment area (102 general practitioners [GPs] in 26 practices) in Northampton, UK.

Patients

Adults who had hip replacements (n=86), knee replacements (n=86), hysterectomies (n=238), chronic obstructive airways disease (COPD) (n=32), or who were elderly medical patients (n=96). Exclusion criteria were age <60 years (except for women having a hysterectomy), hysterectomy for malignancies, and an unsuitable home situation.

Intervention

After randomisation, the HaH group had 37 patients with hip replacement, 47 with knee replacement, 114 with hysterectomy, 15 with COPD, and 50 who were elderly medical patients. The hospital group had 49 patients with hip replacement, 39 with knee replacement, 124 with hysterectomy, 17 with COPD, and 46 who were elderly medical patients. HaH care included nursing, physiotherapy, occupational therapy, pathology, speech therapy, and …

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