Is home hospitalization of acute patients who are admitted due to infection safe and effective?

Abstract

Introduction

Home hospitalization (HH) is a safe, effective and more efficient modality of care than conventional hospitalization (CH). There is little scientific evidence comparing these two models of hospitalization in patients admitted from the Emergency Department (ED) for infection.

Material and methods

Retrospective cohort study between October 1 and December 15, 2023 of patients admitted from the ED for infection. Two cohorts were analyzed, the first one, patients admitted to CH in Internal Medicine, Geriatrics or Infectious Diseases units and the second one, patients admitted to HH. Patients with hemodynamic instability, those who died in the first 48 hours of admission, Staphylococcus aureus bacteremia, catheter-associated bacteremia, osteoarticular infection, meningitis, diverticulitis, fever without focus, and infections with undrained focus were excluded.

Results

257 patients were analyzed, 151 in CH and 106 in HH. The median duration of antibiotherapy was 9 days in HC vs 7 in HH (p < 0.001), the mean length of stay was longer in CH vs HH (6 vs 4; p = 0.007). More laboratory tests were performed in CH vs HH (3 vs 1, p < 0.001), radiographs (11% vs 0%), ultrasound (12% vs 2%) and computed axial tomography (13% vs 3%, p < 0.001). Patients admitted to CH had more confusional syndrome than those admitted to HH (15% vs 2%; p < 0.001). There were no differences in mortality or readmissions. In the multivariate linear regression analysis, patients admitted to HH shortened their hospital stay by 1 day (95% CI: -2.2- -0.185) compared to those admitted to CH.

Conclusion

Patients admitted for infection in HH from the ED have a shorter hospital stay than patients admitted to CH.