Most older people would rather be treated at home than in hospital if their condition allows, since getting care at home is less unsettling.
Now a study of patients who received “Hospital at Home” care has revealed their outcomes were just as good as people admitted to hospital.
As you might expect, patients loved Hospital at Home care.
Could this pave the way for a new, humane approach to treating our older patients?
The study, led by researchers from the Nuffield Department of Population Health at Oxford University, shows that caring for selected vulnerable, older people at home can improve patient outcomes while relieving pressure on hospitals.
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Bear in mind hospital admission itself may cause confusion (delirium) in older people, worsen their mobility and make it more likely they’ll need to move into residential care.
With Hospital at Home the care provided to patients in their homes is the same as in hospital. As on a hospital ward, patients have access to a multi-disciplinary team, medicines, oxygen and intravenous treatment; and they can be transferred to hospital if required. But is Hospital at Home safe and effective?
To answer this question around 1,000 older patients (average age 83 years) were recruited between March 2015 and June 2018 who’d been referred for hospital admission.
Patients were assigned to either hospital or Hospital at Home care. After six months it turned out there was little difference in the proportion of patients who had died.
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Participants in the Hospital at Home scheme were slightly less likely to be in long-term residential care (5.7% vs 8.7%) and there was no difference in cognitive impairment, impact on daily living or new chronic conditions.
Also, after only one month, participants in the Hospital at Home model were slightly less likely to develop delirium (1.7% vs 4.4%).
The study also reported higher levels of patient satisfaction with Hospital at Home care, particularly regarding the length of time waiting for care to start, contacting staff, being involved in decisions and discussing further health or social care services.
According to the study leaders, this shows that hospital-level care in the home is just as beneficial for a selected group of older people as hospital care.
It could provide a new approach that avoids unnecessary stress and disruption for older people and ultimately relieves pressure on our hospital beds.