Amb motiu del tancament d'estiu, la validació de documents es reprendrà a partir del 28 d'agost de 2026. Disculpeu les molèsties.
Con motivo del cierre de verano, la validación de documentos se reanudará a partir del 28 de agosto de 2026. Disculpad las molestias
Due to the summer closure, document validation will resume starting August 28, 2026. We apologize for any inconvenience.

Files

685654.pdf (561.45 KB)

Document type

Article

Version

Published version

Publication date

2018-05-16

Publication license

cc-by (c) Hernández, Carme et al., 2018
Please use this identifier to cite or link to this item: https://hdl.handle.net/2445/156460

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

Journal Title

Authors

Director/Tutor

Journal ISSN

Volume Title

Related resource

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

Abstract

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.

Subject

Malalts crònics, Atenció domiciliària, Salut pública

Subject (English)

Chronically ill, Home care services, Public health

Citation

Collections

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

Citation

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

Export metadata

JSON - METS

Share record