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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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Recurs relacionat

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

Resum

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

Citació

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: 11 of August of 2026]. Available at: https://hdl.handle.net/2445/156460

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