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2018-05-16

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cc-by (c) Hernández, Carme et al., 2018
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/156460

Implementation of home hospitalization and early discharge as an integrated care service: A ten years pragmatic assessment

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https://doi.org/10.5334/ijic.3431

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OBJECTIVE: To evaluate implementation and 10 years follow-up of Home Hospitalization and Early Discharge as an Integrated Care Service in an urban healthcare district in Barcelona. METHODS: Prospective study with pragmatic assessment. Patients: Surgical and medical acute and exacerbated chronic patients requiring admission into a highly specialized hospital, from 2006 to 2015. Intervention: Home-based individualized care plan, administered as a hospital-based outreach service, aiming at substituting hospitalization and implementing a transitional care strategy for optimal discharge. Main measurements: Emergency Department, readmissions and mortality. Patients' and professionals' perspectives, technologies and costs were evaluated. RESULTS: 4,165 admissions (71 ± 15 yrs; Charlson Index 4 ± 3). In-hospital stay was 1 (0-3) days and the length of home-based stay was 6 (5-7) days. The 30-day readmission rate was 11% and mortality was 2%. Patients, careers and health professionals expressed high levels of satisfaction (98%). At the start, the service was reimbursed at a flat rate of 918 per patient discharged, significantly lower than conventional hospitalization (2,879 ) but still allowing the hospital to keep a balanced budget. At present, there is no difference in the payment schemes for both types of services. CONCLUSIONS: The service freed an average of 6 in-hospital days per patient. The program showed health value generation, as well as potential for synergies with community-based Integrated Care Services.

Matèries

Malalts crònics, Atenció domiciliària, Salut pública

Matèries (anglès)

Chronically ill, Home care services, Public health

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Col·leccions

Articles publicats en revistes (Medicina)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

Citació

HERNÁNDEZ, Carme, et al. Implementation of home hospitalization and early discharge as an integrated care service: A ten years pragmatic assessment. International Journal of Integrated Care. 2018. Vol. 18, num. 2, pags. 12. ISSN 1568-4156. [consulted: 22 of May of 2026]. Available at: https://hdl.handle.net/2445/156460

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