#Theme hospital trial trial#
Few studies had a higher level of evidence: only one randomized clinical trial was included. Most studies used telemedicine involving medical diagnostic technologies (10), (electronic) health records (9), specialists (9) and specialized nursing staff (11). Staff satisfaction was mentioned positively in five studies.
Telemedicine consultation reduced the hospitalization of nursing home residents in 14/16 and care costs in 8/11 articles. A total of 1127 articles were retrieved and 923 titles and abstracts were screened, with 16 studies published between 20 being included. To identify available evidence, the electronic databases PubMed, Livivo, EBSCO and JSTOR were searched (without time or regional constraints) for comparative primary research studies on this topic in peer-reviewed journals. This scoping review looked for evidence of a change in the rate of hospitalization and, if mentioned, any cost savings and/or staff acceptance of the use of telemedicine in a nursing home setting. Telemedicine might help reduce the frequency of these potentially risk-associated hospitalizations. The aging of society is increasing the number of hospitalizations of nursing home residents. No significant differences in quality, safety, and patient experience were noted, with more definitive results awaiting a larger trial. The use of substitutive home-hospitalization compared to in-hospital usual care reduced cost and utilization and improved physical activity. Patient experience was similar in both groups.
55% p = 0.08) and fewer readmissions (11% vs.
#Theme hospital trial plus#
Median direct cost for the acute care plus 30-day post-discharge period for home patients was 67% (IQR, 77% p < 0.01) lower, with trends toward less use of home-care services (22% vs. No adverse events occurred in home patients, one occurred in control patients. 78 p < 0.01), with a trend toward more sleep. Home patients were more physically active (median minutes, 209 vs. 19 p < 0.01) and less often received consultations (0% vs.
During the care episode, home patients had fewer laboratory orders (median per admission: 6 vs. Median direct cost of the acute care episode for home patients was 52% (IQR, 28% p = 0.05) lower than for control patients. Nine patients were randomized to home, 11 to usual care. Secondary outcomes included utilization, 30-day cost, physical activity, and patient experience. Primary outcome was direct cost of the acute care episode. Home hospital care, including nurse and physician home visits, intravenous medications, continuous monitoring, video communication, and point-of-care testing. Providing substitutive hospital-level care in a patient's home potentially reduces cost while maintaining or improving quality, safety, and patient experience, although evidence from randomized controlled trials in the US is lacking.ĭetermine if home hospital care reduces cost while maintaining quality, safety, and patient experience.Īdults admitted via the emergency department with any infection or exacerbation of heart failure, chronic obstructive pulmonary disease, or asthma. Hospitals are standard of care for acute illness, but hospitals can be unsafe, uncomfortable, and expensive.
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