Felix Heidi M, Cowdell Jed C, Paulson Margaret R, Maita Karla C, Dugani Sagar B, Avila Francisco R, Torres-Guzman Ricardo A, Forte Antonio J, Matcha Gautam V, Maniaci Michael J
Division of Hospital Internal Medicine, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL 32224, USA.
Division of Hospital Internal Medicine, Mayo Clinic Health Systems, 1221 Whipple St, Eau Claire, WI 54701, USA.
Healthcare (Basel). 2023 Jan 17;11(3):282. doi: 10.3390/healthcare11030282.
In July 2020, Mayo Clinic introduced a hospital-at-home program, known as Advanced Care at Home (ACH) as an alternate option for clinically stable medical patients requiring hospital-level care. This retrospective cohort study evaluates the impact of the addition of a dedicated ACH patient acquisition Advanced Practice Provider (APP) on average length of stay (ALOS) and the number of patients admitted into the program between in Florida and Wisconsin between 6 July 2020 and 31 January 2022. Patient volumes and ALOS of 755 patients were analyzed between the two sites both before and after a dedicated acquisition APP was added to the Florida site on 1 June 2021. The addition of a dedicated acquisition APP did not affect the length of time a patient was in the emergency department or hospital ward prior to ACH transition (2.91 days [Florida] vs. 2.59 days [Wisconsin], = 0.22), the transition time between initiation of the ACH consult to patient transfer home (0.85 days [Florida] vs. 1.16 days [Wisconsin], = 0.28), or the total ALOS (6.63 days [Florida] vs. 6.34 days [Wisconsin], = 0.47). The average number of patients acquired monthly was significantly increased in Florida (38.3 patients per month) compared with Wisconsin (21.6 patients per month) ( < 0.01). The addition of a dedicated patient acquisition APP resulted in significantly higher patient volumes but did not affect transition time or ALOS. Other hospital-at-home programs may consider the addition of an acquisition APP to maximize patient volumes.
2020年7月，梅奥诊所推出了一项居家医院项目，即居家高级护理（ACH），作为需要医院级护理的临床稳定医疗患者的另一种选择。这项回顾性队列研究评估了增加一名专门负责ACH患者获取的高级执业医师（APP）对2020年7月6日至2022年1月31日期间佛罗里达州和威斯康星州患者平均住院时间（ALOS）以及该项目收治患者数量的影响。在2021年6月1日佛罗里达州站点增加一名专门负责获取患者的APP前后，对两个站点的755名患者的患者数量和ALOS进行了分析。增加一名专门负责获取患者的APP并未影响患者在ACH转诊前在急诊科或医院病房的停留时间（佛罗里达州为2.91天，威斯康星州为2.59天，P = 0.22）、从启动ACH咨询到患者转回家的转诊时间（佛罗里达州为0.85天，威斯康星州为1.16天，P = 0.28）或总ALOS（佛罗里达州为6.63天，威斯康星州为6.34天，P = 0.47）。与威斯康星州（每月21.6名患者）相比，佛罗里达州每月获取的患者平均数量显著增加（每月38.3名患者）（P < 0.01）。增加一名专门负责患者获取的APP导致患者数量显著增加，但并未影响转诊时间或ALOS。其他居家医院项目可能会考虑增加一名获取患者的APP，以最大限度地增加患者数量。
