Being hospitalized can be a traumatic experience, especially for older persons. Hospitals are noisy, disorienting, full of strangers and infections often spread among patients.
Now a new study has shown that for older persons with certain acute conditions, hospital-level care can be provided at home for less money and with fewer clinical complications than in-hospital care.
In addition, patients recovered sooner when "hospitalized" at home, the study found, and they and their families were more satisfied with the whole experience.
The program, called Hospital at Home, was carried out by the University at Buffalo, Yale University and Oregon Health and Science University. Bruce Leff, M.D., from The Johns Hopkins University, oversaw the project. Results of the program appear in the current issue (Dec. 6) of Annals of Internal Medicine.
The program in Buffalo was a collaboration among four institutions -- UB, Kaleida Health, Independent Health and Univera.
"The success of our collaboration provides a model for establishing home hospital programs within communities with multiple competing health-care organizations," said Bruce Naughton, M.D., principal investigator on the Buffalo project and director of the UB Division of Geriatrics.
"Work is continuing in Buffalo with the goal of establishing a sustainable home hospital program," added Naughton, associate professor of medicine at UB. The program was carried out in two consecutive 11-month phases. All patient participants came to a hospital suffering from one of four target illnesses: community-acquired pneumonia, exacerbation of chronic heart failure, exacerbation of chronic obstructive pulmonary disease or cellulitis.
The first phase -- which included 60 patients in Buffalo -- took place in participating hospitals. In this phase, 282 persons who met the study criteria, consented to participate and to allow a review of their records served as the "hospital observation comparison group." Through interviews and review of medical records, a study coordinator collected information on the seriousness of illness, health status, medications used, laboratory results, type and course of treatment, complications, and outcomes, and determined if the care met treatment standards.
In addition, a family member or person who knew the patient well was interviewed to determine the patient's dementia experience. Patients and family members were contacted two weeks after discharge to obtain information on the patient's ability to function and satisfaction with care.