Epworth Health Care, Melbourne, VIC.
University of Newcastle, Newcastle, NSW.
Med J Aust. 2020 Jul;213(1):22-27. doi: 10.5694/mja2.50599. Epub 2020 May 1.
To describe uptake of hospital in the home (HIH) by major Australian hospitals and the characteristics of patients and their HIH admissions; to assess change in HIH admission numbers relative to total hospital activity.
Descriptive, retrospective study of HIH activity, analysing previously collected census data for all multi-day hospital inpatient admissions to included hospitals during the period 1 January 2011 - 31 December 2017.
SETTING, PARTICIPANTS: Nineteen principal referrer hospital members of the Health Roundtable in Australia.
HIH admissions by diagnosis-related group (DRG); patient and admission characteristics.
80 167 of 2 185 421 admissions to the 19 hospitals included HIH care, or 3.7% (95% CI, 3.6-3.7%) of all admissions. Median length of stay for admissions including HIH (7.3 days; IQR, 3.1-14 days) was longer than that for those that did not (2.7 days; IQR, 1.6-5.1 days). For HIH admissions, the proportion of men was higher (54.4% v 45.9%), the proportion of patients who died in hospital was lower (0.3% v 1.4%), and re-admission within 28 days was less frequent (2.3% v 3.6%). The 50 DRGs with greatest HIH activity encompassed 65 811 HIH admissions (82.1%), or 8.4% (95% CI, 8.4-8.5%) of all admissions in these DRGs. HIH admission numbers grew more rapidly than non-HIH admissions, but the difference was not statistically significant.
HIH care is most frequently provided to patients requiring hospital treatment related to infections, venous thromboembolism, or post-surgical care. Its use could be expanded in clinical areas where it is currently used, and extended to others where it is not. HIH activity is growing. It should be systematically monitored and reported to allow better overview of its use and outcomes.
描述澳大利亚主要医院的医院居家治疗（HIH）的收治情况，以及患者及其 HIH 入院的特征；评估 HIH 入院人数相对于总住院活动的变化。
对 HIH 活动进行描述性、回顾性研究，分析 2011 年 1 月 1 日至 2017 年 12 月 31 日期间纳入医院所有多日住院患者的先前收集的普查数据。
地点、参与者：澳大利亚卫生圆桌会议的 19 家主要转诊医院成员。
按诊断相关组（DRG）分类的 HIH 入院人数；患者和入院特征。
19 家医院的 2185421 例住院患者中，有 80167 例（3.7%[95%CI，3.6-3.7%]）接受了 HIH 治疗。包括 HIH 治疗的入院患者的中位住院时间（7.3 天；IQR，3.1-14 天）长于未接受 HIH 治疗的患者（2.7 天；IQR，1.6-5.1 天）。HIH 入院患者中，男性比例较高（54.4%比 45.9%），院内死亡比例较低（0.3%比 1.4%），28 天内再入院比例较低（2.3%比 3.6%）。HIH 活动量最大的 50 个 DRG 涵盖了 82161 例 HIH 入院患者（82.1%），占这些 DRG 中所有入院患者的 8.4%（95%CI，8.4-8.5%）。HIH 入院人数的增长速度快于非 HIH 入院人数，但差异无统计学意义。
HIH 治疗主要用于需要治疗感染、静脉血栓栓塞或手术后护理的住院患者。可以在目前使用 HIH 的临床领域扩大其使用范围，并将其扩展到其他尚未使用的领域。HIH 活动正在增长。应系统地监测和报告 HIH 的使用和结果，以便更好地了解其使用情况和结果。
