Home hospitalization: first year of experience in a public hospital.

Abstract

Introduction: Home Hospitalization (HH) is a modality of home care with benefits for the health system, patients, families, and with few experiences in our country. In this paper, we present the results of the first year in a public hospital.

Materials and methods: Cross-sectional study. Patients older than 17 years with acute and clinically stable diseases were included. We analyzed their clinical characteristics, days of hospitalization, mortality, readmission, and patient and family satisfaction surveys. The cost analysis is general, per day/bed, and variable due to the progressive incorporation of human resources and increase of available beds.

Results: A total 276 patients were hospitalized, 51% women, median age 65 years, median number of days of hospitalization 4 and mean Charlson Index 4. The percentage of readmissions was 17.2% and mortality 6.7% at 30 days. Satisfaction surveys were completed by 28.6% of patients and 13.1% of family members: 96-100% reported that they considered all the points evaluated as very good/good. 90-95% stated that they would choose this modality again, that they would recommend this modality, and that they preferred it to hospitalization. The HH cost per bed day was 70% higher than the medical clinic cost per bed day.

Discussion: HH is feasible to implement and accepted in our setting. Its initial costs were higher than those in the medical clinic, but should be re-evaluated in the long term, if bed capacity and human resources remain constant.