Heart failure and community-acquired pneumonia: cases for home hospital?

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It was possible to publish this article open access thanks to a Swiss National Licence with the publisher.
Serval ID
serval:BIB_E25721630863
Type
Article: article from journal or magazin.
Collection
Publications
Title
Heart failure and community-acquired pneumonia: cases for home hospital?
Journal
International Journal for Quality in Health Care
Author(s)
Santos-Eggimann B., Chavaz N., Larequi T., Lamy O., Yersin B.
ISSN
1353-4505
Publication state
Published
Issued date
2001
Peer-reviewed
Oui
Volume
13
Number
4
Pages
301-307
Language
english
Abstract
BACKGROUND: Home hospital is advocated in many western countries in spite of limited evidence of its economic advantage over usual hospital care. Heart failure and community-acquired pneumonia are two medical conditions which are frequently targeted by home hospital programs. While recent trials were devoted to comparisons of safety and costs, the acceptance of home hospital for patients with these conditions remains poorly described. OBJECTIVE: To document the medical eligibility and final transfer decision to home hospital for patients hospitalized with a primary diagnosis of heart failure or community-acquired pneumonia. DESIGN: Longitudinal study of patients admitted to the medical ward of acute care hospitals, up to the final decision concerning their transfer. SETTING: Medical departments of one university hospital and two regional teaching Swiss hospitals. PATIENTS: All patients admitted over a 9 month period to the three settings with a primary diagnosis of heart failure (n= 301) or pneumonia (n=441). MEASUREMENTS: Presence of permanent exclusion criteria on admission; final decision of (in)eligibility based on medical criteria; final decision regarding the transfer, taking into account the opinions of the family physician, the patient and informal caregivers. RESULTS: While 27.9% of heart failure and 37.6% of pneumonia patients were considered to be eligible from a medical point of view, the program acceptance by family physicians, patients and informal caregivers was low and a transfer to home hospital was ultimately chosen for just 3.8% of heart failure and 9.6% of pneumonia patients. There were no major differences between the three settings. CONCLUSIONS: In the case of these two conditions, the potential economic advantage of home hospital over usual inpatient care is compromised by the low proportion of patients ultimately transferred.
Keywords
Aged, Aged, 80 and over, Cardiac Output, Low/therapy, Cohort Studies, Community-Acquired Infections/therapy, Eligibility Determination, Feasibility Studies, Female, Home Care Services, Hospital-Based/organization &amp, administration, Hospitals, Teaching, Hospitals, University, Humans, Longitudinal Studies, Male, Pilot Projects, Pneumonia/therapy, Switzerland
Pubmed
Web of science
Open Access
Yes
Create date
14/03/2008 11:21
Last modification date
25/09/2019 7:11
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