Please use this identifier to cite or link to this item: http://hdl.handle.net/11434/538
Title: Medically-managed Hospital in the Home: 7 year study of mortality and unplanned interuption.
Epworth Authors: Montalto, Michael
Lui, Benjamin
Other Authors: Mullins, Ann
Woodmason, Katherine
Keywords: Hospital In The Home
HIH
Home Care Services
House Calls
Mortality
Acute Hospital Care
Patient Care Outcomes
Unplanned Interruption
Return To Hosptial
Patients At Home
Epworth Hospital in the Home
Internal Medicine Clinical Institute, Epworth HealthCare, Victoria, Australia
Royal Melbourne Hospital, Hospital In The Home
Issue Date: Aug-2010
Publisher: CSIRO
Citation: Aust Health Rev. 2010 Aug;34(3):269-75
Abstract: BACKGROUND: Hospital in the Home (HIH) research is characterised by small samples in new programs. We sought to examine a large number of consecutive HIH admissions over many years in an established, medically-managed HIH service in to determine whether: (1) HIH is a safe and effective method of delivering acute hospital care, under usual operating conditions in an established unit; and (2) what patient, condition and treatment variables contribute to a greater risk of failure. METHODS: A survey of all patients admitted to a medically-managed HIH unit from 2000-2007. RESULTS: A total of 3423 admissions to HIH were examined. Of these 2207 (64.5%) were admitted directly into the HIH from Emergency Department or rooms, with the remainder admitted from hospital wards. A total of 26,653 HIH bed days were delivered. with a mean of 9.3 nursing visits and 4.1 medical visits per admission. A total of 143 patients (4.2%) required an interruption via an unplanned return to hospital; 106(3.1%) did not subsequently return to HIH. The commonest reason for unplanned returns to hospital were: no clinical improvement; cardiac conditions; fevers; breathlessness and pain. Patients over the age of 50, and those receiving intravenous antibiotic therapy, were more likely to require a return to patients died unexpected mortality rate of 0.15%. CONCLUSION: This sample of HIH patients is five time the number of HIH patients ever enrolled in randomised trials studies of this area. Further, outcomes were achieved in 'ordinary' working conditions over a long time period. Care was completed without interruption (return to hospital) in 95.8% of all episodes. Interruption was associated with patients referred from inpatient wards, older patients who were treated with intravenous antibiotics, Patients referred from Emergency Departments experienced fewer interruptions. Nursing home residents were no more likely to required an interruption to their HIH care.
URI: http://hdl.handle.net/11434/538
DOI: 10.1071/AH09771
URL: http://www.publish.csiro.au/?act=view_file&file_id=AH09771.pdf
PubMed URL: http://www.ncbi.nlm.nih.gov/pubmed/20797356
ISSN: 0156-5788
1449-8944
Journal Title: Australian Health Review
Type: Journal Article
Affiliated Organisations: Royal Melbourne Hospital, hosptial in the Home, Grattan St, Parkville, VIC 3052, Australia
Type of Clinical Study or Trial: Survey
Appears in Collections:Health Administration
Internal Medicine

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