Performance of hospital-at-home after a randomised controlled trial
Objective: To compare the performance of an admission-avoidance hospital-at-home scheme one year after the end of a randomised trial with its performance during the trial. Methods: Observational study of patients admitted to the scheme during a period of 12–19 months after the trial ended. In additi...
Gespeichert in:
| Veröffentlicht in: | Journal of health services research & policy 2003-07, Vol.8 (3), p.160-164 |
|---|---|
| Hauptverfasser: | , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 164 |
|---|---|
| container_issue | 3 |
| container_start_page | 160 |
| container_title | Journal of health services research & policy |
| container_volume | 8 |
| creator | Wilson, Andrew Parker, Hilda Wynn, Alison Spiers, Nicky |
| description | Objective: To compare the performance of an admission-avoidance hospital-at-home scheme one year after the end of a randomised trial with its performance during the trial. Methods: Observational study of patients admitted to the scheme during a period of 12–19 months after the trial ended. In addition to routine data from service records, patients were interviewed at three days, two weeks and three months after admission, using the same instruments as used in the trial. Results: All 78 patients admitted to hospital-at-home during the follow-up period were included, and compared with the 95 patients admitted during the trial. The referral rate to hospital-at-home was the same (11 per month) as during the trial. During the trial, patients were randomised to hospital-at-home or hospital, meaning that hospital-at-home worked at about double the trial volume in the post-trial period. Baseline characteristics showed no statistically significant differences except that post-trial patients were less cognitively impaired. There were no statistically significant differences between the groups in survival at two weeks and three months, or in Barthel index, Sickness Impact Profile 68 and Philadelphia Geriatric Morale Scale. Length of stay in hospital-at-home was significantly shorter in the post-trial period (median of five days versus seven, P |
| doi_str_mv | 10.1258/135581903322029511 |
| format | Article |
| fullrecord | <record><control><sourceid>jstor_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_73482981</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><jstor_id>26749983</jstor_id><sage_id>10.1258_135581903322029511</sage_id><sourcerecordid>26749983</sourcerecordid><originalsourceid>FETCH-LOGICAL-c307t-25d63eb6731f29a8088de78de26d6712a6fbb999c779580eb37725aad50e59903</originalsourceid><addsrcrecordid>eNqFkM1LxDAQxYMo7rr6DwhKT97qZpLm6yiLX7CgBz2XtJ26XdpmTdqD_72RLnoQ9DDMHH7v8eYRcg70GpjQS-BCaDCUc8YoMwLggMxBCZ0ClfQw3hFIIyFn5CSELaXAJehjMgOmpeEZm5PVM_ra-c72JSauTjYu7JrBtqkd0o3rMLH1gD6xibd95bomYJWUrh-8a9t4Dr6x7Sk5qm0b8Gy_F-T17vZl9ZCun-4fVzfrtORUDSkTleRYSMWhZsZqqnWFKg6TlVTArKyLwhhTKmWEplhwpZiwthIUhYlvLsjV5Lvz7n3EMOQxT4lta3t0Y8gVzzQzGv4FhaIZqMxEkE1g6V0IHut855vO-o8caP7Vcf674yi63LuPRYfVj2RfagSWExDsG-ZbN_o-1vK35cWk2IbB-W9HJmNIozn_BOEvjH8</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>57041749</pqid></control><display><type>article</type><title>Performance of hospital-at-home after a randomised controlled trial</title><source>MEDLINE</source><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><source>JSTOR Archive Collection A-Z Listing</source><creator>Wilson, Andrew ; Parker, Hilda ; Wynn, Alison ; Spiers, Nicky</creator><creatorcontrib>Wilson, Andrew ; Parker, Hilda ; Wynn, Alison ; Spiers, Nicky</creatorcontrib><description>Objective: To compare the performance of an admission-avoidance hospital-at-home scheme one year after the end of a randomised trial with its performance during the trial. Methods: Observational study of patients admitted to the scheme during a period of 12–19 months after the trial ended. In addition to routine data from service records, patients were interviewed at three days, two weeks and three months after admission, using the same instruments as used in the trial. Results: All 78 patients admitted to hospital-at-home during the follow-up period were included, and compared with the 95 patients admitted during the trial. The referral rate to hospital-at-home was the same (11 per month) as during the trial. During the trial, patients were randomised to hospital-at-home or hospital, meaning that hospital-at-home worked at about double the trial volume in the post-trial period. Baseline characteristics showed no statistically significant differences except that post-trial patients were less cognitively impaired. There were no statistically significant differences between the groups in survival at two weeks and three months, or in Barthel index, Sickness Impact Profile 68 and Philadelphia Geriatric Morale Scale. Length of stay in hospital-at-home was significantly shorter in the post-trial period (median of five days versus seven, P<0.001), and more patients received a visit from their general practitioner during the period of admission (54% versus 38%, P = 0.04); otherwise there were no significant differences in process measures. Conclusion: Apart from working at higher volume and achieving a shorter length of stay, performance of the hospital-at-home scheme a year after the trial ended was little different from that reported during the trial. This is an example of an observational study providing evidence to support the generalisability of trial findings.</description><identifier>ISSN: 1355-8196</identifier><identifier>EISSN: 1758-1060</identifier><identifier>DOI: 10.1258/135581903322029511</identifier><identifier>PMID: 12869342</identifier><language>eng</language><publisher>London, England: The Royal Society of Medicine Press Limited</publisher><subject>Aged ; Aged, 80 and over ; England ; Evaluation ; Family Practice - statistics & numerical data ; Female ; Follow-Up Studies ; Health administration ; Health Services Research ; Home Care Services, Hospital-Based - standards ; Home Care Services, Hospital-Based - utilization ; Hospital at home schemes ; Hospitals - standards ; Hospitals - utilization ; Humans ; Male ; Original research ; Patient Admission ; Patient Readmission ; Program Evaluation ; Proportional Hazards Models ; Randomized controlled trials ; Referral and Consultation - statistics & numerical data ; Survival Analysis ; Treatment Outcome ; Workload</subject><ispartof>Journal of health services research & policy, 2003-07, Vol.8 (3), p.160-164</ispartof><rights>The Royal Society of Medicine Press Ltd 2003</rights><rights>Royal Society of Medicine Press Limited 2003</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c307t-25d63eb6731f29a8088de78de26d6712a6fbb999c779580eb37725aad50e59903</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/26749983$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/26749983$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,780,784,803,27924,27925,31000,58017,58250</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12869342$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wilson, Andrew</creatorcontrib><creatorcontrib>Parker, Hilda</creatorcontrib><creatorcontrib>Wynn, Alison</creatorcontrib><creatorcontrib>Spiers, Nicky</creatorcontrib><title>Performance of hospital-at-home after a randomised controlled trial</title><title>Journal of health services research & policy</title><addtitle>J Health Serv Res Policy</addtitle><description>Objective: To compare the performance of an admission-avoidance hospital-at-home scheme one year after the end of a randomised trial with its performance during the trial. Methods: Observational study of patients admitted to the scheme during a period of 12–19 months after the trial ended. In addition to routine data from service records, patients were interviewed at three days, two weeks and three months after admission, using the same instruments as used in the trial. Results: All 78 patients admitted to hospital-at-home during the follow-up period were included, and compared with the 95 patients admitted during the trial. The referral rate to hospital-at-home was the same (11 per month) as during the trial. During the trial, patients were randomised to hospital-at-home or hospital, meaning that hospital-at-home worked at about double the trial volume in the post-trial period. Baseline characteristics showed no statistically significant differences except that post-trial patients were less cognitively impaired. There were no statistically significant differences between the groups in survival at two weeks and three months, or in Barthel index, Sickness Impact Profile 68 and Philadelphia Geriatric Morale Scale. Length of stay in hospital-at-home was significantly shorter in the post-trial period (median of five days versus seven, P<0.001), and more patients received a visit from their general practitioner during the period of admission (54% versus 38%, P = 0.04); otherwise there were no significant differences in process measures. Conclusion: Apart from working at higher volume and achieving a shorter length of stay, performance of the hospital-at-home scheme a year after the trial ended was little different from that reported during the trial. This is an example of an observational study providing evidence to support the generalisability of trial findings.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>England</subject><subject>Evaluation</subject><subject>Family Practice - statistics & numerical data</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Health administration</subject><subject>Health Services Research</subject><subject>Home Care Services, Hospital-Based - standards</subject><subject>Home Care Services, Hospital-Based - utilization</subject><subject>Hospital at home schemes</subject><subject>Hospitals - standards</subject><subject>Hospitals - utilization</subject><subject>Humans</subject><subject>Male</subject><subject>Original research</subject><subject>Patient Admission</subject><subject>Patient Readmission</subject><subject>Program Evaluation</subject><subject>Proportional Hazards Models</subject><subject>Randomized controlled trials</subject><subject>Referral and Consultation - statistics & numerical data</subject><subject>Survival Analysis</subject><subject>Treatment Outcome</subject><subject>Workload</subject><issn>1355-8196</issn><issn>1758-1060</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqFkM1LxDAQxYMo7rr6DwhKT97qZpLm6yiLX7CgBz2XtJ26XdpmTdqD_72RLnoQ9DDMHH7v8eYRcg70GpjQS-BCaDCUc8YoMwLggMxBCZ0ClfQw3hFIIyFn5CSELaXAJehjMgOmpeEZm5PVM_ra-c72JSauTjYu7JrBtqkd0o3rMLH1gD6xibd95bomYJWUrh-8a9t4Dr6x7Sk5qm0b8Gy_F-T17vZl9ZCun-4fVzfrtORUDSkTleRYSMWhZsZqqnWFKg6TlVTArKyLwhhTKmWEplhwpZiwthIUhYlvLsjV5Lvz7n3EMOQxT4lta3t0Y8gVzzQzGv4FhaIZqMxEkE1g6V0IHut855vO-o8caP7Vcf674yi63LuPRYfVj2RfagSWExDsG-ZbN_o-1vK35cWk2IbB-W9HJmNIozn_BOEvjH8</recordid><startdate>20030701</startdate><enddate>20030701</enddate><creator>Wilson, Andrew</creator><creator>Parker, Hilda</creator><creator>Wynn, Alison</creator><creator>Spiers, Nicky</creator><general>The Royal Society of Medicine Press Limited</general><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7X8</scope></search><sort><creationdate>20030701</creationdate><title>Performance of hospital-at-home after a randomised controlled trial</title><author>Wilson, Andrew ; Parker, Hilda ; Wynn, Alison ; Spiers, Nicky</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c307t-25d63eb6731f29a8088de78de26d6712a6fbb999c779580eb37725aad50e59903</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>England</topic><topic>Evaluation</topic><topic>Family Practice - statistics & numerical data</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Health administration</topic><topic>Health Services Research</topic><topic>Home Care Services, Hospital-Based - standards</topic><topic>Home Care Services, Hospital-Based - utilization</topic><topic>Hospital at home schemes</topic><topic>Hospitals - standards</topic><topic>Hospitals - utilization</topic><topic>Humans</topic><topic>Male</topic><topic>Original research</topic><topic>Patient Admission</topic><topic>Patient Readmission</topic><topic>Program Evaluation</topic><topic>Proportional Hazards Models</topic><topic>Randomized controlled trials</topic><topic>Referral and Consultation - statistics & numerical data</topic><topic>Survival Analysis</topic><topic>Treatment Outcome</topic><topic>Workload</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wilson, Andrew</creatorcontrib><creatorcontrib>Parker, Hilda</creatorcontrib><creatorcontrib>Wynn, Alison</creatorcontrib><creatorcontrib>Spiers, Nicky</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of health services research & policy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wilson, Andrew</au><au>Parker, Hilda</au><au>Wynn, Alison</au><au>Spiers, Nicky</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Performance of hospital-at-home after a randomised controlled trial</atitle><jtitle>Journal of health services research & policy</jtitle><addtitle>J Health Serv Res Policy</addtitle><date>2003-07-01</date><risdate>2003</risdate><volume>8</volume><issue>3</issue><spage>160</spage><epage>164</epage><pages>160-164</pages><issn>1355-8196</issn><eissn>1758-1060</eissn><abstract>Objective: To compare the performance of an admission-avoidance hospital-at-home scheme one year after the end of a randomised trial with its performance during the trial. Methods: Observational study of patients admitted to the scheme during a period of 12–19 months after the trial ended. In addition to routine data from service records, patients were interviewed at three days, two weeks and three months after admission, using the same instruments as used in the trial. Results: All 78 patients admitted to hospital-at-home during the follow-up period were included, and compared with the 95 patients admitted during the trial. The referral rate to hospital-at-home was the same (11 per month) as during the trial. During the trial, patients were randomised to hospital-at-home or hospital, meaning that hospital-at-home worked at about double the trial volume in the post-trial period. Baseline characteristics showed no statistically significant differences except that post-trial patients were less cognitively impaired. There were no statistically significant differences between the groups in survival at two weeks and three months, or in Barthel index, Sickness Impact Profile 68 and Philadelphia Geriatric Morale Scale. Length of stay in hospital-at-home was significantly shorter in the post-trial period (median of five days versus seven, P<0.001), and more patients received a visit from their general practitioner during the period of admission (54% versus 38%, P = 0.04); otherwise there were no significant differences in process measures. Conclusion: Apart from working at higher volume and achieving a shorter length of stay, performance of the hospital-at-home scheme a year after the trial ended was little different from that reported during the trial. This is an example of an observational study providing evidence to support the generalisability of trial findings.</abstract><cop>London, England</cop><pub>The Royal Society of Medicine Press Limited</pub><pmid>12869342</pmid><doi>10.1258/135581903322029511</doi><tpages>5</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1355-8196 |
| ispartof | Journal of health services research & policy, 2003-07, Vol.8 (3), p.160-164 |
| issn | 1355-8196 1758-1060 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_73482981 |
| source | MEDLINE; Applied Social Sciences Index & Abstracts (ASSIA); JSTOR Archive Collection A-Z Listing |
| subjects | Aged Aged, 80 and over England Evaluation Family Practice - statistics & numerical data Female Follow-Up Studies Health administration Health Services Research Home Care Services, Hospital-Based - standards Home Care Services, Hospital-Based - utilization Hospital at home schemes Hospitals - standards Hospitals - utilization Humans Male Original research Patient Admission Patient Readmission Program Evaluation Proportional Hazards Models Randomized controlled trials Referral and Consultation - statistics & numerical data Survival Analysis Treatment Outcome Workload |
| title | Performance of hospital-at-home after a randomised controlled trial |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-04T11%3A13%3A25IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-jstor_proqu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Performance%20of%20hospital-at-home%20after%20a%20randomised%20controlled%20trial&rft.jtitle=Journal%20of%20health%20services%20research%20&%20policy&rft.au=Wilson,%20Andrew&rft.date=2003-07-01&rft.volume=8&rft.issue=3&rft.spage=160&rft.epage=164&rft.pages=160-164&rft.issn=1355-8196&rft.eissn=1758-1060&rft_id=info:doi/10.1258/135581903322029511&rft_dat=%3Cjstor_proqu%3E26749983%3C/jstor_proqu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=57041749&rft_id=info:pmid/12869342&rft_jstor_id=26749983&rft_sage_id=10.1258_135581903322029511&rfr_iscdi=true |