Effectiveness of admission-avoidance hospital at home as alternative to routine hospital care in older adults: a systematic review and meta-analysis

This is the authors' abstract. We don't add key points for this paper.

This systematic review and meta-analysis aimed to assess the effectiveness of home-based programmes to prevent hospital admissions compared with traditional hospital-based care for older adults. Health outcomes analysed included readmission rates, mortality, and length of treatment. Data from 15 studies were synthesised using Review Manager (version 5.4), and heterogeneity was assessed using forest plots and I 2 statistics. Subgroup analyses were performed for randomised controlled trials and for specific patient groups, such as those with cardiovascular and respiratory disease. The results suggest that hospital at home programmes may reduce the risk of readmission (risk ratio = 0.76, 95% CI 0.58 to 1.01, P = 0.05), especially for patients with respiratory diseases (risk ratio = 0.53, 95% CI 0.39 to 0.73, P = 0.00007), with no significant differences in mortality or treatment duration between groups. • Admission avoidance hospital-at-home programs have the potential to improve health outcomes and reduce hospital stays for older adults. • There is a paucity of systematic evidence evaluating the effectiveness of admission avoidance hospital-at-home programs for the elderly population. • This study found that admission avoidance hospital-at-home programs could reduce the risk of readmission, particularly among patients with respiratory diseases. • Admission avoidance hospital-at-home programs exhibited comparable efficacy to conventional hospital care regarding mortality rate and treatment duration.