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

https://doi.org/10.1136/ebn.2.2.50

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    Richards SH, Coast J, Gunnell DJ, et al.Randomised controlled trial comparing effectiveness and acceptability of an early discharge, hospital at home scheme with acute hospital care.BMJ1998 Jun 13;316:1796–801OpenUrlAbstract/FREE Full TextCoast J, Richards SH, Peters TJ, et al.Hospital at home or acute hospital care? A cost minimisation analysis.BMJ1998 Jun 13;316:1802–6OpenUrlAbstract/FREE Full Text

    Question Is “hospital at home” (HaH) care as effective and cost effective as inpatient hospital care for medically stable elderly patients?

    Design

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

    Setting

    Hospital wards and their catchment areas in Bristol, UK.

    Patients

    241 of 383 older adults (median age 79 y, 69% women) who were in hospital and medically stable. Inclusion criteria were availability of staff, expected positive rehabilitation, need for further hospital care if a HaH programme was not available, suitable home situation, agreement from the general practitioner (GP), and expected hospital stay of 1–28 days. Exclusion criterion was waiting for nursing home placement.

    Intervention

    After stratifying for type of admission (elective or emergency), randomisation was done to achieve twice as many patients in the HaH group. 160 patients allocated to the HaH group were discharged when they could be managed using routinely available community services. They received healthcare services between 8:30 am and 11:00 pm, or as …

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    Footnotes

    • Sources of funding: South and West National Health Service Research and Development Directorate and in part, Avon Health Authority.

    • For correspondence: Suzanne Richards, Research Associate, Room 2.4, Department of Social Medicine, University of Bristol, Bristol BS8 2PR, UK. Fax +44 (0)117 928 7340.

    • ↵* Calculated from data in article.