Implementation of home hospitalization and early discharge as an integrated care service: A ten years pragmatic assessment

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RECERCAT Home > Universitat de Barcelona > IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer > Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer) > View document

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dc.contributor.author	Hernández, Carme
dc.contributor.author	Aibar Gallizo, Jesús
dc.contributor.author	Seijas, Nuria
dc.contributor.author	Puig, Imma
dc.contributor.author	Alonso, Albert
dc.contributor.author	García Aymerich, Judith
dc.contributor.author	Roca Torrent, Josep
dc.date	2020-04-21T13:58:58Z
dc.date	2020-04-21T13:58:58Z
dc.date	2018-05-16
dc.date	2020-04-21T13:59:00Z
dc.identifier	1568-4156
dc.identifier	685654
dc.identifier.uri	http://hdl.handle.net/2445/156460
dc.description	OBJECTIVE: To evaluate implementation and 10 years follow-up of Home Hospitalization and Early Discharge as an Integrated Care Service in an urban healthcare district in Barcelona. METHODS: Prospective study with pragmatic assessment. Patients: Surgical and medical acute and exacerbated chronic patients requiring admission into a highly specialized hospital, from 2006 to 2015. Intervention: Home-based individualized care plan, administered as a hospital-based outreach service, aiming at substituting hospitalization and implementing a transitional care strategy for optimal discharge. Main measurements: Emergency Department, readmissions and mortality. Patients' and professionals' perspectives, technologies and costs were evaluated. RESULTS: 4,165 admissions (71 ± 15 yrs; Charlson Index 4 ± 3). In-hospital stay was 1 (0-3) days and the length of home-based stay was 6 (5-7) days. The 30-day readmission rate was 11% and mortality was 2%. Patients, careers and health professionals expressed high levels of satisfaction (98%). At the start, the service was reimbursed at a flat rate of 918 per patient discharged, significantly lower than conventional hospitalization (2,879 ) but still allowing the hospital to keep a balanced budget. At present, there is no difference in the payment schemes for both types of services. CONCLUSIONS: The service freed an average of 6 in-hospital days per patient. The program showed health value generation, as well as potential for synergies with community-based Integrated Care Services.
dc.format	11 p.
dc.format	application/pdf
dc.language	eng
dc.publisher	Universiteit Utrecht
dc.relation	Reproducció del document publicat a: https://doi.org/10.5334/ijic.3431
dc.relation	International Journal of Integrated Care, 2018, vol. 18, num. 2, p. 12
dc.relation	https://doi.org/10.5334/ijic.3431
dc.relation	info:eu-repo/grantAgreement/EC/H2020/689802/EU//CONNECARE
dc.rights	cc-by (c) Hernández, Carme et al., 2018
dc.rights	http://creativecommons.org/licenses/by/3.0/es
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	Malalts crònics
dc.subject	Atenció domiciliària
dc.subject	Salut pública
dc.subject	Chronically ill
dc.subject	Home care services
dc.subject	Public health
dc.title	Implementation of home hospitalization and early discharge as an integrated care service: A ten years pragmatic assessment
dc.type	info:eu-repo/semantics/article
dc.type	info:eu-repo/semantics/publishedVersion

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