Beatriz Farinha-Costa MD, MSc , Paulo Reis-Pina MD, MSc, PhD
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引用次数: 0
Abstract
Context
Home hospitalization (HHOSP) is an alternative care model aimed at alleviating pressure on healthcare systems and catering to the increasing patient population. It aligns with the preference for home-based palliative care (PALC) and end-of-life care.
Objectives
This study systematically reviewed the literature to evaluate HHOSP's role in PALC, focusing on hospital readmissions, length of stay, patient and caregiver safety and satisfaction, place of death, and overall survival.
Methods
A systematic search was conducted in PubMed, Scopus, and Web of Science databases from 2013 to 2023. Participants: patients of any age or gender diagnosed with advanced, metastatic, or incurable cancer or advanced dementia. Intervention: HHOSP. Comparator: usual care. Outcomes: hospital readmissions, length of stay, patient and caregiver safety and satisfaction, place of death, and overall survival. The risk of bias was assessed using Cochrane tools.
Results
Six studies with 843 participants from Denmark, France, Spain, and Israel were included. The overall risk of bias was moderate to high. HHOSP reduced hospital readmissions, with 42.2%–91% of patients avoiding further hospitalizations. Caregivers reported feeling safe and satisfied with HHOSP, experiencing reduced burden. Most patients died at home (52.2%–75%). Median overall survival ranged from 28 days–11.2 months.
Conclusion
The findings highlight HHOSP's potential as an alternative for delivering PALC, reducing hospital readmissions, and improving patient and caregiver satisfaction. Despite heterogeneity in study designs and outcomes, HHOSP aligns with patient and caregiver preferences, enhancing the quality of end-of-life care. Further standardized research is needed to optimize HHOSP implementation.
期刊介绍:
The Journal of Pain and Symptom Management is an internationally respected, peer-reviewed journal and serves an interdisciplinary audience of professionals by providing a forum for the publication of the latest clinical research and best practices related to the relief of illness burden among patients afflicted with serious or life-threatening illness.