Key result
Hospital in the home treatment for acute decompensated heart failure showed no significant difference in 60-day mortality (P=0.5) or 30-day readmissions (P=0.7) compared to in-hospital treatment.
Why the study?
To compare outcomes of readmission, mortality, and treatment-related complications in older patients treated by hospital in the home versus in-hospital care for acute decompensated CCF.
Does hospital in the home (HITH) treatment reduce readmission, mortality, and complications in patients 65 years and older with acute decompensated congestive cardiac failure compared to traditional in-hospital treatment?
Cohort
Does hospital in the home (HITH) treatment reduce readmission, mortality, and complications in patients 65 years and older with acute decompensated congestive cardiac failure compared to traditional in-hospital treatment?
Hospital in the home is a safe and cost-effective alternative to traditional inpatient care for older patients with acute decompensated heart failure, yielding similar mortality and readmission rates.
HITH was associated with similar outcomes in older HF patients; leaves open confirmation by randomized trials.
OBJECTIVES: To compare the outcomes of readmission, mortality and treatment-related complications in older people treated by hospital in the home (HITH) for acute decompensated congestive cardiac failure (CCF) with those treated in hospital. METHODS: Retrospective cohort study of patients 65 years and older treated by HITH over a 30-month period compared with age- and sex-matched patients treated in hospital. RESULTS: There was no difference between the "HITH" and "Hospital" cohorts in mortality within 60 days of discharge (P = 0.5), time to death (P = 0.8), 30-day (P = 0.7) and 60-day (P = 0.4) readmissions, time to readmission (P = 0.9) and complication rate (P = 0.1). HITH patients had longer length of stay (P = 0.001) but lower cost per day of admission ($669.42 vs $1377.58). CONCLUSION: In appropriately selected older patients, HITH is a safe, efficacious and cost-effective alternative to inpatient management of acute decompensated CCF.
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Yu et al. (2019) conducted a cohort in Acute decompensated congestive cardiac failure. Hospital in the home (HITH) vs. In-hospital treatment was evaluated on Mortality within 60 days of discharge (p=0.5). Hospital in the home treatment for acute decompensated heart failure showed no significant difference in 60-day mortality (P=0.5) or 30-day readmissions (P=0.7) compared to in-hospital treatment.
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