Implementation of Home Hospitalization and Early Discharge as an Integrated Care Service
A Ten Years Pragmatic Assessment
Bibliographic Data
| ID | 12833515 |
|---|---|
| Authors | C Hernández (0000-0002-8414-9309, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias), Jesús Aibar (0000-0001-5415-3449, Hospital Clínic de Barcelona), Núria Seijas (0000-0001-6267-9125, Hospital Clínic de Barcelona), IMMA PUIG (Hospital Clínic de Barcelona), Albert Alonso (0000-0003-0921-8033, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias), Judith García‐Aymerich (0000-0002-7097-4586, Universitat Pompeu Fabra), Josep Roca (0000-0003-4768-8722, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, corresponding author) |
| Year | 2018 |
| Volume | 18 |
| Issue | 0 |
| Pages | 12-12 |
| Publication date | 2018-05-16 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | International Journal of Integrated Care (JOURNAL) |
| Journal identifiers | ISSN: 1568-4156 • E-ISSN: 1568-4156 |
| Publisher | Ubiquity Press (PUBLISHER • GB) |
| DOI | 10.5334/ijic.3431 |
| OpenAlex | W2803485220 |
| Language | EN |
| Citations received | 2 |
| References cited | 37 |
Home Hospitalization has proven efficacy, but its effectiveness and potential as an Integrated Care Service in a real world setting deserves to be explored.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
Business · Health care · Integrated care · Medical emergency · Political science · Service (business · Family and Patient Care in Intensive Care Units · Frailty in Older Adults · Geriatric Care and Nursing Homes · Medicine · Nursing
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| Unique citing works | 2 |
|---|---|
| Citations per year | 0.5 |
| Citation span | 2022 - 2023 (2) |
| Citation velocity | historical |
| Highly cited | No |
| Citation types | Neutral: 1 |