To evaluate the clinical outcomes, safety, and cost-effectiveness of a comprehensive Hospital-at-Home (HAH) service in England, addressing gaps in existing literature.
Key Findings:
HAH reduced length of stay by 3.13 days compared to inpatient controls (95% CI 2.60–3.67, p < 1 × 10−29).
Total bed-day savings amounted to 13,119 days, resulting in net savings of £3.79 million over 33 months.
30-day readmission rates were significantly lower in HAH cohorts (OR 0.55, 95% CI 0.42–0.70, p < 3 × 10−6).
Total time in hospital over 90 days was reduced by 2.64 days (95% CI 1.87–3.40, p < 2 × 10−11).
90-day all-cause mortality was significantly lower in HAH cohorts (OR 0.43, 95% CI 0.35–0.53, p < 3 × 10−16).
Interpretation:
HAH services significantly reduce length of stay, readmissions, and healthcare costs while maintaining safety and potentially reducing mortality, supporting wider implementation and informing future healthcare policy.
Limitations:
Retrospective design may introduce bias.
Exclusions may limit generalizability of findings.
Potential confounding factors, such as patient comorbidities and socioeconomic status, were not fully controlled.
Conclusion:
The study demonstrates the effectiveness of HAH services in improving patient outcomes and reducing healthcare costs, advocating for broader adoption in light of these findings.
by Michael Shaw, Batool Almogheer, Dominique Auger, Andrew Barlow, Balasmita Bhaskaran, Maria Buxton, Marco Cerulli, Kalpana Giri Ghimire, Edward Hiller, Zoe Jayne, Michal Kelly, Matthew Knight, Eleanor Zinkin, Niall G. Keenan
