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Hospital-Level Home Acute Care Can Cut Costs, Health Care Use

Less frequent readmission seen within 30 days with hospital-level care at home for acutely ill

Home care

TUESDAY, Dec. 17, 2019 (HealthDay News) -- For acutely ill adults, hospital-level care at home is associated with reduced costs, health care use, and readmissions compared with usual hospital care, according to a study published online Dec. 17 in the Annals of Internal Medicine.

David M. Levine, M.D., M.P.H., from Brigham and Women's Hospital and Harvard Medical School in Boston, and colleagues conducted a randomized controlled trial involving 91 adults admitted via the emergency department with selected acute conditions. Forty-three patients received acute care at home and 48 received usual hospital care.

The researchers found that compared with control patients, the adjusted mean cost of the acute care episode was 38 percent lower for home patients. Home patients also had fewer laboratory orders than controls (median per admission, three versus 15), fewer imaging studies (median, 14 versus 44 percent), and fewer consultations (median, 2 versus 31 percent). The proportion of the day spent sedentary (median, 12 versus 23 percent) or lying down (median, 18 versus 55 percent) was lower for home patients versus controls. Home patients also were less frequently readmitted within 30 days (7 versus 23 percent).

"Reimagining the best place to care for selected acutely ill adults holds enormous potential," the authors write. "Further work is needed to better understand the conditions and illness severity of patients who could be successfully cared for at home."

Several authors disclosed financial ties to the pharmaceutical and medical technology industries.

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