OBJECTIVE: To assess the effect of "hospital in the home" (HITH) services that significantly substitute for inhospital time on mortality, readmission rates, patient and carer satisfaction, and costs. DATA SOURCES: MEDLINE, Embase, Social Sciences Citation Index, CINAHL, EconLit, PsycINFO and the Cochrane Database of Systematic Reviews, from the earliest date in each database to 1 February 2012. STUDY SELECTION: Randomised controlled trials (RCTs) comparing HITH care with inhospital treatment for patients aged > 16 years. DATA EXTRACTION: Potentially relevant studies were reviewed independently by two assessors, and data were extracted using a collection template and checklist. DATA SYNTHESIS: 61 RCTs met the inclusion criteria. HITH care led to reduced mortality (odds ratio [OR], 0.81; 95% CI, 0.69 to 0.95; P = 0.008; 42 RCTs with 6992 patients), readmission rates (OR, 0.75; 95% CI, 0.59 to 0.95; P = 0.02; 41 RCTs with 5372 patients) and cost (mean difference, -1567.11; 95% CI, -2069.53 to -1064.69; P < 0.001; 11 RCTs with 1215 patients). The number needed to treat at home to prevent one death was 50. No heterogeneity was observed for mortality data, but heterogeneity was observed for data relating to readmission rates and cost. Patient satisfaction was higher in HITH in 21 of 22 studies, and carer satisfaction was higher in and six of eight studies; carer burden was lower in eight of 11 studies, although not significantly (mean difference, 0.00; 95% CI, -0.19 to 0.19). CONCLUSION: HITH is associated with reductions in mortality, readmission rates and cost, and increases in patient and carer satisfaction, but no change in carer burden.
OBJECTIVE: To assess the effect of "hospital in the home" (HITH) services that significantly substitute for inhospital time on mortality, readmission rates, patient and carer satisfaction, and costs. DATA SOURCES: MEDLINE, Embase, Social Sciences Citation Index, CINAHL, EconLit, PsycINFO and the Cochrane Database of Systematic Reviews, from the earliest date in each database to 1 February 2012. STUDY SELECTION: Randomised controlled trials (RCTs) comparing HITH care with inhospital treatment for patients aged > 16 years. DATA EXTRACTION: Potentially relevant studies were reviewed independently by two assessors, and data were extracted using a collection template and checklist. DATA SYNTHESIS: 61 RCTs met the inclusion criteria. HITH care led to reduced mortality (odds ratio [OR], 0.81; 95% CI, 0.69 to 0.95; P = 0.008; 42 RCTs with 6992 patients), readmission rates (OR, 0.75; 95% CI, 0.59 to 0.95; P = 0.02; 41 RCTs with 5372 patients) and cost (mean difference, -1567.11; 95% CI, -2069.53 to -1064.69; P < 0.001; 11 RCTs with 1215 patients). The number needed to treat at home to prevent one death was 50. No heterogeneity was observed for mortality data, but heterogeneity was observed for data relating to readmission rates and cost. Patient satisfaction was higher in HITH in 21 of 22 studies, and carer satisfaction was higher in and six of eight studies; carer burden was lower in eight of 11 studies, although not significantly (mean difference, 0.00; 95% CI, -0.19 to 0.19). CONCLUSION: HITH is associated with reductions in mortality, readmission rates and cost, and increases in patient and carer satisfaction, but no change in carer burden.
Authors: Nicholas T Bott; Clifford C Sheckter; Daniel Yang; Stephanie Peters; Brian Brady; Scooter Plowman; Soo Borson; Bruce Leff; Robert M Kaplan; Terry Platchek; Arnold Milstein Journal: Am J Geriatr Psychiatry Date: 2018-09-28 Impact factor: 4.105
Authors: Quincy M Samus; Betty Smith Black; Diane Bovenkamp; Michael Buckley; Christopher Callahan; Karen Davis; Laura N Gitlin; Nancy Hodgson; Deirdre Johnston; Helen C Kales; Michele Karel; John Jay Kenney; Shari M Ling; Maï Panchal; Melissa Reuland; Amber Willink; Constantine G Lyketsos Journal: Alzheimers Dement Date: 2017-11-21 Impact factor: 21.566
Authors: David M Levine; Kei Ouchi; Bonnie Blanchfield; Keren Diamond; Adam Licurse; Charles T Pu; Jeffrey L Schnipper Journal: J Gen Intern Med Date: 2018-02-06 Impact factor: 5.128
Authors: Andrew McWilliams; Jason Roberge; William E Anderson; Charity G Moore; Whitney Rossman; Stephanie Murphy; Stephannie McCall; Ryan Brown; Shannon Carpenter; Scott Rissmiller; Scott Furney Journal: J Gen Intern Med Date: 2018-08-14 Impact factor: 5.128