Key result
The provided text is a user guide for the Canadian Classification of Health Interventions (CCI) 2022, detailing its structure, coding conventions, and implementation across Canada.
Why the study?
There is a paucity of data on the clinical outcomes of Canadian Hospital at Home programs.
Does a Hospital at Home program improve clinical outcomes compared to brick-and-mortar hospitalization?
Does a Hospital at Home program improve clinical outcomes compared to brick-and-mortar hospitalization?
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“The Ministry of Health told the hospital administration here that they should be expecting a steady increase in the need for inpatient beds over the next several decades. Hospital-at-home was floated as one potential way to tackle that.”
“Everything is delivered from the hospital system as if the patients were in a physical ward.”
“To be honest, I do see Hospital at Home being the future of health-care delivery for a certain subset of patients.”
A Canadian Hospital at Home program was associated with lower mortality and readmission rates but higher fall rates compared to traditional hospitalization.
Importance The safety of Hospital at Home (HaH) has been demonstrated by many high-quality studies; however, there is a paucity of data on Canadian HaH programs. Objective This study evaluates the clinical outcomes of the HaH program in Victoria, British Columbia, Canada. Design and Setting We conducted an observational quality outcomes analysis comparing HaH and brick-and-mortar (BAM) groups using data from the national Discharge Abstract Database (DAD). Risk adjustment was applied to control for clinical and demographic differences. Adjusted outcome rates were estimated using multivariable regression models, and group differences were assessed with two-proportions Z-tests on predicted probabilities. Primary statistical conclusions were based on regression-derived effect estimates and their corresponding confidence intervals. Participants Among 25,624 abstracts reviewed, 1,129 (4.2%) were HaH patients. Results HaH patients had a lower incidence of Hospital Harm (5.0% vs. 7.8%) including hospital-acquired delirium (0.8% vs. 2.0%), but a higher fall rate (20.4 vs. 8.2 per 1,000). HaH patients had a lower 30-day readmission rate (9.1% vs. 13.7%), and a lower 30-day mortality rate (1.0% vs. 2.8%). The Actual vs. Expected Length of Stay ratio was significantly higher for HaH patients (1.59 vs 1.19). Conclusions Victoria’s HaH program appears to offer a safe alternative to BAM hospitalization, with comparable or better clinical outcomes in several key areas. These findings support the expansion of HaH in Canada.
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Spina et al. (2026) studied this question. The provided text is a user guide for the Canadian Classification of Health Interventions (CCI) 2022, detailing its structure, coding conventions, and implementation across Canada.
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