Randomised controlled trial comparing effectiveness and acceptability of an early discharge, hospital at home scheme with acute hospital care.

Abstract:

OBJECTIVE:To compare effectiveness and acceptability of early discharge to a hospital at home scheme with that of routine discharge from acute hospital. DESIGN:Pragmatic randomised controlled trial. SETTING:Acute hospital wards and community in north of Bristol, with a catchment population of about 224 000 people. SUBJECTS:241 hospitalised but medically stable elderly patients who fulfilled criteria for early discharge to hospital at home scheme and who consented to participate. INTERVENTIONS:Patients' received hospital at home care or routine hospital care. MAIN OUTCOME MEASURES:Patients' quality of life, satisfaction, and physical functioning assessed at 4 weeks and 3 months after randomisation to treatment; length of stay in hospital and in hospital at home scheme after randomisation; mortality at 3 months. RESULTS:There were no significant differences in patient mortality, quality of life, and physical functioning between the two arms of the trial at 4 weeks or 3 months. Only one of 11 measures of patient satisfaction was significantly different: hospital at home patients perceived higher levels of involvement in decisions. Length of stay for those receiving routine hospital care was 62% (95% confidence interval 51% to 75%) of length of stay in hospital at home scheme. CONCLUSIONS:The early discharge hospital at home scheme was similar to routine hospital discharge in terms of effectiveness and acceptability. Increased length of stay associated with the scheme must be interpreted with caution because of different organisational characteristics of the services.

journal_name

BMJ

authors

Richards SH,Coast J,Gunnell DJ,Peters TJ,Pounsford J,Darlow MA

doi

10.1136/bmj.316.7147.1796

subject

Has Abstract

pub_date

1998-06-13 00:00:00

pages

1796-801

issue

7147

eissn

0959-8138

issn

1756-1833

journal_volume

316

pub_type

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