Internal Medicine at Home: Three Years of Experience with a Novel Model.

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Tác giả: Zaher S Azzam, Gidon Berger, Eyal Braun, Doron Cohn-Schwartz, Henda Darawsha, Avi Magid, Jamal Qarawany, Rizan Sakhnini, Carmit Steinberg, Yoav Weber, Zivit Zalts

Ngôn ngữ: eng

Ký hiệu phân loại: 296.71 Religious experience

Thông tin xuất bản: Israel : The Israel Medical Association journal : IMAJ , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 51290

BACKGROUND: Hospital-at-Home (HaH) programs offer medical services in the patient's home as an alternative to hospitalization across various medical fields. Previous studies have demonstrated that HaH provides several benefits for patients and the healthcare system. Rambam Health Care Center was the pioneer hospital in introducing HaH in Israel. Since April 2021, in collaboration with Maccabi Healthcare Services, the center has been providing home hospitalization services for patients with acute internal medicine illnesses based on an innovative model. OBJECTIVES: To describe demographic data, background diseases, indications for HaH admissions, length of stay (LOS), 1-month and 1-week readmission rates, home mortality, and 1-month mortality. RESULTS: The study included 262 patients (135 men, 127 women), mean age 69.7 years (range 24-98, median 73). Patients had significant co-morbidities, with a Charlson Comorbidity Index score of 6.7. Among the patients, 170 were independent, 61 were incapacitated, and the remainder had various functional limitations. Most admissions were from internal medicine departments, 39 originating from the emergency department and the rest from other acute care wards. The primary indications for HaH admission included pneumonia, urinary tract infections, and cellulitis. The average hospital LOS was 48.9 hours, while the HaH LOS was 3.43 days. Readmission rates for the same initial conditions were 10% within 1 week and 14% within 1 month. Twenty-one patients died within 1 month of discharge from HaH, including one death during the HaH period. CONCLUSIONS: This study highlighted the feasibility of home hospitalization as a viable alternative to traditional inpatient care in internal medicine.
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