M Montalto1, D Dunt. 1. Hospital in the Home Unit, Mornington Peninsula Hospital, Vic.
Abstract
AIM: To study the severity, treatment and outcome of patients with cellulitis and pyelonephritis treated with intravenous antibiotics in either a hospital in the home unit (HHU) or traditional inpatient beds. METHOD: Retrospective case reviews were used. All patients with cellulitis and pyelonephritis from January 1995 until January 1996 who were assessed as appropriate for HHU care were included. Each HHU case was included. The traditional in-hospital group was defined as patients who had been assessed as suitable for HHU, but who did not enter the HHU for non-clinical reasons. Background variables were: patient age; patient gender; prior treatment with antibiotics; temperature on presentations; creatinine on presentation; leucocyte count on presentation; parenteral medication used; and preexistent conditions. Outcome variables were: number of days until febrifuge; total duration of stay; duration of in-hospital stay; duration of HHU stay; patient incidents; and status at discharge. RESULTS: The two groups exhibited similarities on patient and condition characteristics, although differences in the types of antibiotics used were found. A positive clinical outcome was achieved in every patient. In-hospital duration of stay was briefer in the HHU groups. DISCUSSION: These early results are encouraging for home intravenous therapy. Further studies, controlled trials if possible, are now required to establish these findings more definitively.
AIM: To study the severity, treatment and outcome of patients with cellulitis and pyelonephritis treated with intravenous antibiotics in either a hospital in the home unit (HHU) or traditional inpatient beds. METHOD: Retrospective case reviews were used. All patients with cellulitis and pyelonephritis from January 1995 until January 1996 who were assessed as appropriate for HHU care were included. Each HHU case was included. The traditional in-hospital group was defined as patients who had been assessed as suitable for HHU, but who did not enter the HHU for non-clinical reasons. Background variables were: patient age; patient gender; prior treatment with antibiotics; temperature on presentations; creatinine on presentation; leucocyte count on presentation; parenteral medication used; and preexistent conditions. Outcome variables were: number of days until febrifuge; total duration of stay; duration of in-hospital stay; duration of HHU stay; patient incidents; and status at discharge. RESULTS: The two groups exhibited similarities on patient and condition characteristics, although differences in the types of antibiotics used were found. A positive clinical outcome was achieved in every patient. In-hospital duration of stay was briefer in the HHU groups. DISCUSSION: These early results are encouraging for home intravenous therapy. Further studies, controlled trials if possible, are now required to establish these findings more definitively.
Authors: Paul Corwin; Les Toop; Graham McGeoch; Martin Than; Simon Wynn-Thomas; J Elisabeth Wells; Robin Dawson; Paul Abernethy; Alan Pithie; Stephen Chambers; Lynn Fletcher; Dee Richards Journal: BMJ Date: 2004-12-16