‘Hospital at home’ care model as an effective alternative in the management of decompensated chronic heart failure
| Autor: | Humberto Manuel Trujillo Mendoza, Felipe Aizpuru, Pedro Lopetegui, Angel García, José Regalado De Los Cobos, María Jesús Martín, Bello Mc, Fernando Arós, Juan Miguel Cia |
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| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Decompensated chronic heart failure MEDLINE Home Care Services Hospital-Based Patient Readmission law.invention Quality of life Randomized controlled trial law Health care medicine Humans Intensive care medicine Aged Heart Failure business.industry Emergency department medicine.disease Comorbidity Hospitalization Spain Heart failure Chronic Disease Emergency medicine Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Journal of Heart Failure. 11:1208-1213 |
| ISSN: | 1388-9842 |
| DOI: | 10.1093/eurjhf/hfp143 |
| Popis: | Aims The ‘Hospital at home’ (HaH) model avoids hospital admission by transferring healthcare and treatment to the patient's home. We aimed to compare the effectiveness and direct healthcare costs of treating elderly patients with decompensated heart failure (HF) using HaH care vs. inpatient hospital care (IHC) in a cardiology unit. Methods and results Eighty patients aged over 65 years who presented at the emergency department with decompensated HF were randomly assigned to IHC or HaH. All patients were studied for 1 year. Seventy-one patients completed the study, of these 34 were admitted to cardiology and 37 received HaH care. No significant differences were found in baseline characteristics, including comorbidity, functional status, and health-related quality of life. Clinical outcomes were similar after initial admission and also after the 12 months of follow-up. Death or re-admission due to HF or another cardiovascular event occurred in 19 patients in IHC and 20 in HaH (P = 0.88). Changes in functional status and health-related quality of life over the follow-up period were not significantly different. The average cost of the initial admission was 4502 ± 2153€ in IHC and 2541 ± 1334€ in HaH (P < 0.001). During 12 months of follow-up, the average expenditure was 4619 ± 7679€ and 3425 ± 4948€ (P = 0.83) respectively. Conclusion Hospital at home care allows an important reduction in the costs during the index episode compared with hospital care, whilst maintaining similar outcomes with respect to cardiovascular mortality and morbidity and quality of life at 1 year follow-up. |
| Databáze: | OpenAIRE |
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