Hernández, CarmeAibar Gallizo, JesúsSeijas, NuriaPuig, ImmaAlonso, AlbertGarcía Aymerich, JudithRoca Torrent, Josep2020-04-212020-04-212018-05-161568-4156https://hdl.handle.net/2445/156460OBJECTIVE: 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.11 p.application/pdfengcc-by (c) Hernández, Carme et al., 2018http://creativecommons.org/licenses/by/3.0/esMalalts crònicsAtenció domiciliàriaSalut públicaChronically illHome care servicesPublic healthinfo:eu-repo/semantics/article6856542020-04-21info:eu-repo/semantics/openAccess30127696