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The Impact of a Hybrid Hospital at Home Program in Reducing Subacute Rehabilitation

PURPOSE: The purpose of this study was to compare health outcomes for patients receiving acute care in their homes through a Hospital at Home (HaH) program to outcomes for inpatients in the traditional hospital setting. PATIENTS AND METHODS: We compared outcomes for patients in a HaH program at Virt...

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Autores principales: Yadav, Ravi R, Mahyoub, Mohammed A, Capriotti, Michael W, Berio-Dorta, Raul L, Dougherty, Kacie, Shukla, Ajit
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10625393/
https://www.ncbi.nlm.nih.gov/pubmed/37927908
http://dx.doi.org/10.2147/RMHP.S419862
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author Yadav, Ravi R
Mahyoub, Mohammed A
Capriotti, Michael W
Berio-Dorta, Raul L
Dougherty, Kacie
Shukla, Ajit
author_facet Yadav, Ravi R
Mahyoub, Mohammed A
Capriotti, Michael W
Berio-Dorta, Raul L
Dougherty, Kacie
Shukla, Ajit
author_sort Yadav, Ravi R
collection PubMed
description PURPOSE: The purpose of this study was to compare health outcomes for patients receiving acute care in their homes through a Hospital at Home (HaH) program to outcomes for inpatients in the traditional hospital setting. PATIENTS AND METHODS: We compared outcomes for patients in a HaH program at Virtua Health in 2022 (N = 271) to traditional inpatients during the same year (N = 13,776) with the same diagnoses. We defined outcomes as recommendations for subacute rehabilitation (SAR) upon discharge as this recommendation indicates the need for additional therapy based on a physician’s assessment of the patient. Specifically, we searched notes in the electronic medical records for terms related to recommendation for SAR using text mining algorithms and a natural language processing (NLP) model to confirm these recommendations. We then compared the proportion of patients within each group that had a SAR recommendation, and controlled for differences in sample size, age, and diagnosis using bootstrapping analyses. RESULTS: We observed that the proportion of patients in the HaH program that were recommended for SAR (0.148) was significantly different from the proportion of patients who remained in the traditional hospital setting (0.363), with a reduced need for SAR for HaH patients. We obtained qualitatively similar results when we controlled for sample size and diagnosis. Controlling for age yielded an older control population, and the difference in the proportion of patients with SAR recommendations between the groups widened. CONCLUSION: The reduced need for SAR for HaH patients in this study suggests that HaH programs are a promising alternative care model. Future work may consider how health outcomes vary for patients with different diagnoses, clinical histories and demographics, which may inform how HaH programs operate moving forward.
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spelling pubmed-106253932023-11-05 The Impact of a Hybrid Hospital at Home Program in Reducing Subacute Rehabilitation Yadav, Ravi R Mahyoub, Mohammed A Capriotti, Michael W Berio-Dorta, Raul L Dougherty, Kacie Shukla, Ajit Risk Manag Healthc Policy Original Research PURPOSE: The purpose of this study was to compare health outcomes for patients receiving acute care in their homes through a Hospital at Home (HaH) program to outcomes for inpatients in the traditional hospital setting. PATIENTS AND METHODS: We compared outcomes for patients in a HaH program at Virtua Health in 2022 (N = 271) to traditional inpatients during the same year (N = 13,776) with the same diagnoses. We defined outcomes as recommendations for subacute rehabilitation (SAR) upon discharge as this recommendation indicates the need for additional therapy based on a physician’s assessment of the patient. Specifically, we searched notes in the electronic medical records for terms related to recommendation for SAR using text mining algorithms and a natural language processing (NLP) model to confirm these recommendations. We then compared the proportion of patients within each group that had a SAR recommendation, and controlled for differences in sample size, age, and diagnosis using bootstrapping analyses. RESULTS: We observed that the proportion of patients in the HaH program that were recommended for SAR (0.148) was significantly different from the proportion of patients who remained in the traditional hospital setting (0.363), with a reduced need for SAR for HaH patients. We obtained qualitatively similar results when we controlled for sample size and diagnosis. Controlling for age yielded an older control population, and the difference in the proportion of patients with SAR recommendations between the groups widened. CONCLUSION: The reduced need for SAR for HaH patients in this study suggests that HaH programs are a promising alternative care model. Future work may consider how health outcomes vary for patients with different diagnoses, clinical histories and demographics, which may inform how HaH programs operate moving forward. Dove 2023-10-31 /pmc/articles/PMC10625393/ /pubmed/37927908 http://dx.doi.org/10.2147/RMHP.S419862 Text en © 2023 Yadav et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Yadav, Ravi R
Mahyoub, Mohammed A
Capriotti, Michael W
Berio-Dorta, Raul L
Dougherty, Kacie
Shukla, Ajit
The Impact of a Hybrid Hospital at Home Program in Reducing Subacute Rehabilitation
title The Impact of a Hybrid Hospital at Home Program in Reducing Subacute Rehabilitation
title_full The Impact of a Hybrid Hospital at Home Program in Reducing Subacute Rehabilitation
title_fullStr The Impact of a Hybrid Hospital at Home Program in Reducing Subacute Rehabilitation
title_full_unstemmed The Impact of a Hybrid Hospital at Home Program in Reducing Subacute Rehabilitation
title_short The Impact of a Hybrid Hospital at Home Program in Reducing Subacute Rehabilitation
title_sort impact of a hybrid hospital at home program in reducing subacute rehabilitation
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10625393/
https://www.ncbi.nlm.nih.gov/pubmed/37927908
http://dx.doi.org/10.2147/RMHP.S419862
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