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dc.contributor.author | Hernández, Carme |
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dc.contributor.author | Aibar Gallizo, Jesús |
dc.contributor.author | Seijas, Nuria |
dc.contributor.author | Puig, Imma |
dc.contributor.author | Alonso, Albert |
dc.contributor.author | García Aymerich, Judith |
dc.contributor.author | Roca Torrent, Josep |
dc.date | 2020-04-21T13:58:58Z |
dc.date | 2020-04-21T13:58:58Z |
dc.date | 2018-05-16 |
dc.date | 2020-04-21T13:59:00Z |
dc.identifier | 1568-4156 |
dc.identifier | 685654 |
dc.identifier.uri | http://hdl.handle.net/2445/156460 |
dc.description | OBJECTIVE: To evaluate implementation and 10 years follow-up of Home Hospitalization and Early Discharge as an Integrated Care Service in an urban healthcare district in Barcelona. METHODS: Prospective study with pragmatic assessment. Patients: Surgical and medical acute and exacerbated chronic patients requiring admission into a highly specialized hospital, from 2006 to 2015. Intervention: Home-based individualized care plan, administered as a hospital-based outreach service, aiming at substituting hospitalization and implementing a transitional care strategy for optimal discharge. Main measurements: Emergency Department, readmissions and mortality. Patients' and professionals' perspectives, technologies and costs were evaluated. RESULTS: 4,165 admissions (71 ± 15 yrs; Charlson Index 4 ± 3). In-hospital stay was 1 (0-3) days and the length of home-based stay was 6 (5-7) days. The 30-day readmission rate was 11% and mortality was 2%. Patients, careers and health professionals expressed high levels of satisfaction (98%). At the start, the service was reimbursed at a flat rate of 918 per patient discharged, significantly lower than conventional hospitalization (2,879 ) but still allowing the hospital to keep a balanced budget. At present, there is no difference in the payment schemes for both types of services. CONCLUSIONS: The service freed an average of 6 in-hospital days per patient. The program showed health value generation, as well as potential for synergies with community-based Integrated Care Services. |
dc.format | 11 p. |
dc.format | application/pdf |
dc.language | eng |
dc.publisher | Universiteit Utrecht |
dc.relation | Reproducció del document publicat a: https://doi.org/10.5334/ijic.3431 |
dc.relation | International Journal of Integrated Care, 2018, vol. 18, num. 2, p. 12 |
dc.relation | https://doi.org/10.5334/ijic.3431 |
dc.relation | info:eu-repo/grantAgreement/EC/H2020/689802/EU//CONNECARE |
dc.rights | cc-by (c) Hernández, Carme et al., 2018 |
dc.rights | http://creativecommons.org/licenses/by/3.0/es |
dc.rights | info:eu-repo/semantics/openAccess |
dc.subject | Malalts crònics |
dc.subject | Atenció domiciliària |
dc.subject | Salut pública |
dc.subject | Chronically ill |
dc.subject | Home care services |
dc.subject | Public health |
dc.title | Implementation of home hospitalization and early discharge as an integrated care service: A ten years pragmatic assessment |
dc.type | info:eu-repo/semantics/article |
dc.type | info:eu-repo/semantics/publishedVersion |