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Background Hospital-at-home (HaH) is a healthcare modality that provides active treatment by healthcare staff in the patient’s home for a condition that would otherwise require hospitalization. Previous studies have described two basic types of HaH: hospital admission avoidance and early discharge The aims of this study were: To describe the characteristics of different types of hospital-at-home (HaH) contacts; to assess readmission, mortality, and mean length of stay for each HaH modality; and to examine which factors could be related to these results. Methods A cross-sectional study based on data from all 2014 HaH contacts from Catalonia was designed. The following HaH modalities were considered: admission avoidance (n=7,214; 75.1%) and early discharge (n=2,387; 24.9%). The main outcome indicators were readmission, mortality, and mean length of stay (days). Contact characteristics were compared at bivariable level and indicators were calculated for each HaH modality. Multivariable General linear models were fitted to assess the association between explanatory factors and outcomes. Results Differences in contact characteristics between HaH modalities were observed at bivariable level. In the hospital avoidance modality there were 8.3% readmissions, 0.9% mortality, and a mean length of stay (SD) of 9.6 (10.6) days. In the early discharge one, these figures were 7.9%, 0.5%, and 9.8 (11.1), respectively. In both modalities, readmission and mean length of stay were related to comorbidity and type of hospital, and mortality with age. Conclusions The results show that the HaH results in Catalonia are acceptable and similar to those observed in other contexts. The factors related to these results could help improve the effectiveness and efficiency of the different HaH modalities. |
