Hospital in the home (HiTH) provides acute or subacute care in a patient’s home, that normally would require a hospital stay. HiTH has consistently been shown to improve patient outcomes and reduce health care costs. The characteristics and outcomes of patients receiving HiTH care in the South Western Sydney Local Health District (SWSLHD) has not been well described.
This project aimed to describe the characteristics and outcomes of HiTH services across the SWSLHD.
The characteristics of patients referred to HiTH between January 2017 and December 2019, the indications for HiTH, and representation rates to hospital emergency department (ED) will be presented.
Between January 2017 and December 2019 there was 7,118 referrals to the LHDs HiTH services, among 6,083 patients (3,094 females, 51%), median age 56 years (IQR, 40 - 69). The majority of indications for HiTH were for IV medications (78%, n = 5,552), followed by post-operative drain management (11%, n = 789), rehab in the home (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 HiTH only occurred on 172 (2%) of occasions. The average length of HiTH treatment was 7-days (IQR 4 - 16). Rates of presentation to ED for HiTH patients has 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 for trend < 0.001.
Hospital in the Home Services across the SWSLHD are predominately for administration of IV medications, but include management of post-operative drains, bridging of anticoagulant therapy, and rehab in the home. Importantly, only a very small proportion (3%) of HiTH episodes will results in an unplanned presentation to the ED.
Hospital in the 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.