Characteristics and outcomes of patients receiving Hospital at Home Services in the South West of Sydney

BACKGROUND: Hospital at home (HaH) provides acute or subacute care in a patient's home, that normally would require a hospital stay. HaH has consistently been shown to improve patient outcomes and reduce health care costs. The characteristics and outcomes of patients receiving HaH care across the South Western Sydney Local Health District (SWSLHD) has not been well described. This project aimed to describe the characteristics and outcomes of HaH services across the SWSLHD. METHODS: The characteristics of patients referred to HaH between January 2017 and December 2019, the indications for HaH, and representation rates to hospital emergency department (ED) will be presented. RESULTS: Between January 2017 and December 2019 there was 7118 referrals to the local health district's (LHD) HaH services, among 6083 patients (3094 females, 51%), median age 56 years (Interquartile range (IQR), 40-69). The majority of indications for HaH were for intravenous venous (IV) medications (78%, n = 5552), followed by post-operative drain management (11%, n = 789), rehab in the home (RiTH) (5%, n = 334), bridging anticoagulant therapy (4%, n = 261), and intraperitoneal medications (1%, n = 100). The requirement for presentation to an ED for care, while receiving HaH only occurred on 172 (2%) of occasions. The average length of HaH treatment was 7-days (IQR 4-16). Rates of presentation to ED for HaH patients have decreased since 2017, 3.4% (95% CI 2.7-4.2%), 2018 2.1% (95% CI 1.5-2.8%), and 2019 1.8% (95% CI 1.3-2.4%), p-value for trend < 0.001. CONCLUSION: Hospital at Home is well established, diverse, and safe clinical service to shorten, or avoid hospitalisation, for many patients. Importantly, avoidance of hospitalisation can avoid many risks that are associated with being cared for in the hospital setting.