Outcomes of hospital in the home treatment of acute decompensated congestive cardiac failure compared to traditional in-hospital treatment in older patients

Australas J Ageing. 2020 Mar;39(1):e77-e85. doi: 10.1111/ajag.12697. Epub 2019 Jul 19.

Abstract

Objectives: To compare the outcomes of readmission, mortality and treatment-related complications in older people treated by hospital in the home (HITH) for acute decompensated congestive cardiac failure (CCF) with those treated in hospital.

Methods: Retrospective cohort study of patients 65 years and older treated by HITH over a 30-month period compared with age- and sex-matched patients treated in hospital.

Results: There was no difference between the "HITH" and "Hospital" cohorts in mortality within 60 days of discharge (P = 0.5), time to death (P = 0.8), 30-day (P = 0.7) and 60-day (P = 0.4) readmissions, time to readmission (P = 0.9) and complication rate (P = 0.1). HITH patients had longer length of stay (P = 0.001) but lower cost per day of admission ($669.42 vs $1377.58).

Conclusion: In appropriately selected older patients, HITH is a safe, efficacious and cost-effective alternative to inpatient management of acute decompensated CCF.

Keywords: episodes of care; geriatrics; health services research; heart failure; home care services; patient safety.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Costs and Cost Analysis
  • Female
  • Heart Failure / complications
  • Heart Failure / mortality
  • Heart Failure / therapy*
  • Humans
  • Length of Stay
  • Male
  • Patient Readmission
  • Quality Assurance, Health Care
  • Retrospective Studies