دورية أكاديمية
Hospital-Level Care at Home for Patients with Cirrhosis.
| العنوان: | Hospital-Level Care at Home for Patients with Cirrhosis. |
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| المؤلفون: | Kahn-Boesel O; Harvard Medical School, Boston, MA, USA., Mitchell H; Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA., Li L; Liver Center, Gastrointestinal Division, Massachusetts General Hospital, Boston, MA, USA., Zhu E; Liver Center, Gastrointestinal Division, Massachusetts General Hospital, Boston, MA, USA., El-Jawahri A; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA., Levine D; Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA., Ufere NN; Liver Center, Gastrointestinal Division, Massachusetts General Hospital, Boston, MA, USA. nneka.ufere@mgh.harvard.edu.; Liver Center, Gastrointestinal Unit, Department of Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA. nneka.ufere@mgh.harvard.edu. |
| المصدر: | Digestive diseases and sciences [Dig Dis Sci] 2024 May; Vol. 69 (5), pp. 1669-1673. Date of Electronic Publication: 2024 Mar 11. |
| نوع المنشور: | Journal Article; Multicenter Study |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer Science + Business Media Country of Publication: United States NLM ID: 7902782 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-2568 (Electronic) Linking ISSN: 01632116 NLM ISO Abbreviation: Dig Dis Sci Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2005- : New York, NY : Springer Science + Business Media Original Publication: New York, Plenum Pub. Corp. |
| مواضيع طبية MeSH: | Liver Cirrhosis*/therapy, Humans ; Male ; Female ; Middle Aged ; Aged ; Patient Readmission/statistics & numerical data ; Home Care Services, Hospital-Based ; Home Care Services/statistics & numerical data |
| مستخلص: | Background: Patients with cirrhosis have a 30-day readmission rate of over 30%. Novel care delivery models are needed to reduce healthcare costs and utilization associated with cirrhosis care. One such model is Home Hospital (HH), which provides inpatient-level care at home. Limited evidence currently exists supporting HH for cirrhosis patients. Aims: The aims of this study were to characterize patients with cirrhosis who received hospital-level care at home in a two-site clinical trial and to describe the care they received. Secondary aims included describing their outcomes, including adverse events, readmissions and mortality. Methods: We identified all patients with cirrhosis who enrolled in HH as part of a two-site clinical trial between 2017 and 2022. HH services include daily clinician visits, intravenous and oral medications, continuous vital sign monitoring, and telehealth specialist consultation. We collected sociodemographic data and analyzed HH stays, including interventions, outcomes, adverse events, and follow-up. Results: 22 patients with cirrhosis (45% Hispanic; 50% limited English proficiency, median MELD-Na 12) enrolled in HH during the study period. Interventions included lab chemistries (82%), intravenous medications (77%), specialist consultation (23%), and advanced diagnostics/procedures (23%). The median length of stay was 7 days (IQR 4-12); 186 bed-days were saved. Two patients (9%) experienced adverse events (AKI). No patients required escalation of care; 9% were readmitted within 30 days. Conclusions: In this two-site study, HH was feasible for patients with cirrhosis, holding promise as a hepatology delivery model. Future randomized trials are needed to further evaluate the efficacy of HH for patients with cirrhosis. (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.) |
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| معلومات مُعتمدة: | Division of Gastroenterology Innovation and Collaboration Award Massachusetts General Hospital |
| فهرسة مساهمة: | Keywords: Decompensated cirrhosis; Healthcare costs; Hospital at home; Readmissions |
| تواريخ الأحداث: | Date Created: 20240311 Date Completed: 20240516 Latest Revision: 20240704 |
| رمز التحديث: | 20240705 |
| DOI: | 10.1007/s10620-024-08361-5 |
| PMID: | 38466464 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1573-2568 |
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| DOI: | 10.1007/s10620-024-08361-5 |