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.
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