Academic literature on the topic 'Hospital in the Home (HITH) Program (Vic )'
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Journal articles on the topic "Hospital in the Home (HITH) Program (Vic )"
1
Cooper, Genevieve. "Hospital in the Home in Victoria: Factors Influencing Allocation Decisions." Australian Journal of Primary Health 5, no. 1 (1999): 60. http://dx.doi.org/10.1071/py99007.
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There is a question surrounding the funding of Hospital in the Home (HITH) as to whether the allocation policy was driven by customer service preference or was largely a financial imperative. HITH has the capacity to increase the throughput and therefore the efficiency of acute care facilities which is attractive to Government and Health Service Managers. There is insufficient evidence to indicate that this is true in all circumstances. Hospital in the Home is a desirable and safe option for some clients. Hospital in the Home has the potential to provide a more cost effective mode of delivery of acute care than hospital facilities. However, there is a need for identification of which clients, with which conditions and care needs, will benefit from being part of a HITH program in emotional, health and financial terms. Health professionals are still grappling with the impact that HITH has on their roles and relationships with other health care providers. More qualitative and quantitative research needs to be undertaken to identify the best models of HITH in both organisational and financial tems, and its impact on the wellbeing of clients and carers.
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Page, Jude, Elizabeth Comino, Mandy Burgess, John Cullen, and Elizabeth Harris. "Participation in Hospital in the Home for patients in inner metropolitan Sydney: implications for access and equity." Australian Health Review 42, no. 5 (2018): 557. http://dx.doi.org/10.1071/ah18117.
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Objective The aim of this study was to identify whether the Hospital in the Home (HITH) program was taken up equitably by eligible patients in relation to their age, sex, country of birth, place of residence and primary diagnosis. Methods This study presents results of a descriptive analysis of the administrative records of 3552 people with specific conditions who met the study criteria of potential eligibility to HITH and resided within the health district boundary. Results Systematic differences were found for participation in HITH and in-patient care according to sex, language spoken at home and socioeconomic status based on place of residence. This suggests that people from higher socioeconomic backgrounds who speak English at home were more likely to participate in and benefit from HITH. Tailored interventions were identified as a potential way to reduce the gap in access to quality health care for women and people who speak a language other than English at home. If HITH is the optimum treatment available, then these differences could be considered potentially avoidable and unfair. Conclusion Data analysis through an equity lens can effectively identify who is accessing health services and who is missing out. Further analysis is required to understand patient and system barriers to accessing HITH. What is known about the topic? Advances in medical and surgical treatments and pharmaceuticals reduce the need for in-patient hospitalisation. For some conditions, home-based treatment is safer, cheaper and preferable to the patient and carers, particularly some older people who may experience deteriorating cognitive and physical functioning related to hospitalisation. It is well known that health and access to health care is not equally distributed in society. What does this paper add? This study represents the first effort to quantitatively evaluate differences in patterns of participation in HITH related to socioeconomic and language characteristics. There are underutilised opportunities for improved participation in HITH by identifying who is not accessing programs at a comparable rate and therefore not benefitting from optimal health services. By exploring why this may be occurring at an individual and system level, we can be more informed to address these reasons and achieve better health and social outcomes. What are the implications for practitioners? It is important to consider both consumer and service provider views in shaping current and future service models. Comprehensive assessment of support needs to participate in HITH for patients and carers, as well as communicating potential benefits in ways patients understand, can improve participation and satisfaction, reduce health costs and improve health outcomes.
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Marsh, Nicole, Emily Larsen, Sam Tapp, Margarette Sommerville, Gabor Mihala, and Claire M. Rickard. "Management of Hospital In The Home (HITH) Peripherally Inserted Central Catheters: A Retrospective Cohort Study." Home Health Care Management & Practice 32, no. 1 (August 30, 2019): 34–39. http://dx.doi.org/10.1177/1084822319873334.
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Worldwide, there has been a shift in health care delivery, with an increasing emphasis on avoiding hospital admissions and providing treatment such as intravenous antibiotics for patients at home, using peripherally inserted central catheters (PICCs). However, there is inadequate data to demonstrate if rates of PICC failure are similar for hospital inpatients, currently understood to be between 7% and 36%, than those cared for at home. The objective of this study was to identify prevalence, dwell time, and complications associated with PICCs in the home setting. This single-center, retrospective cohort study of adults treated by the “Hospital in the Home” (HITH) program in Queensland, was conducted between June 1, 2017 and June 15, 2018. Clinical data were collected for patient and PICC characteristics. Variables were described as frequencies and proportions, means and standard deviations, or medians and interquartile ranges. In total, 304 patients treated by HITH during this timeframe, and 164 (54%) patients with 181 PICCs were included in this study. These patients were predominately male (n = 105, 64%), with a mean age of 54 years. The most common reason for admission was a wound infection and/or bone infection (n = 120, 33%). Most PICCs were single lumen (n = 120; 67%), inserted in the basilic vein (n = 137; 80%) by nurses (n = 122; 67%). Peripherally inserted central catheter failure occurred in 10% (n = 19); the most common complications were dislodgement (n = 9; 5%) and thrombosis (n = 4; 2%). There were no confirmed catheter-related blood stream infections. Peripherally inserted central catheter failure rates are similar between hospitalized inpatients and those cared for at home.
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Ashley Appa, Ayesha, Carina Marquez, and Vivek Jain. "753. Outpatient Parenteral Antibiotic Therapy (OPAT) in a Large Urban Safety Net Hospital Setting: Therapy for Vulnerable Populations at Home." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S336. http://dx.doi.org/10.1093/ofid/ofz360.821.
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Abstract Background Adoption of outpatient parenteral antibiotic therapy (OPAT) is accelerating due to proven safety and value, but experience in safety-net settings remains limited, especially in those with history of illicit drug use. Emerging reports from safety-net settings have featured OPAT delivered in nursing facilities, respite care centers, and infusion centers (including some persons who inject drugs [PWID]), but literature is sparse on home-based OPAT for vulnerable patients. In a new home antibiotics program at San Francisco General Hospital, we sought to describe early safety and efficacy outcomes among adults without active injection drug use but with high rates of substance use and comorbid illnesses. Methods We conducted a cohort study of patients discharged from a large urban county medical center and enrolled in an outpatient IV antibiotics program from September 2017 to January 2019. We collected demographic and clinical data and computed outcomes of safety (30- and 90-day readmission for infection, vascular access complications, and death) and efficacy (completion of antibiotic therapy). Results Overall, 47 courses of antibiotics were given to 45 patients. Of these, 39/47 (83%) of antibiotic courses were administered in a residential setting, and 8/47 (17%) via the hospital outpatient infusion center. Comorbid conditions were common, including 9/45 (20%) with hepatitis B/C and 8/45 (18%) with HIV (Table 1). Present or prior illicit drug use was seen in 17/45 patients (38%), including recent or active illicit drug use in 11/45 (24%) (Table 1). Most common indications for antibiotics were osteomyelitis and bacteremia (Table 2). Efficacy in the OPAT program was high: overall, 44/47 (94%) courses of outpatient IV antibiotics were completed, and the 30-day and 90-day readmission rates were 13% and 20% respectively, with zero 30-day readmissions related to OPAT (Table 3). Conclusion An OPAT program embedded within a safety net hospital system delivering care in patients’ homes had high completion rate and low readmission rate, despite patients’ high prevalence of underlying comorbid conditions and noninjection illicit drug use. Home-based OPAT should be considered for broader adoption in safety-net hospital systems. Disclosures All authors: No reported disclosures.
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Keng, Christine J. S., Alifiya Goriawala, Saira Rashid, Rachel Goldstein, Selina Schmocker, Alexandra Easson, and Erin Kennedy. "Home to Stay: An Integrated Monitoring System Using a Mobile App to Support Patients at Home Following Colorectal Surgery." Journal of Patient Experience 7, no. 6 (February 12, 2020): 1241–46. http://dx.doi.org/10.1177/2374373520904194.
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Background: Patients undergoing colorectal surgery are vulnerable during their transition from hospital to home and require increased support following discharge from hospital. Study objectives were to perform an initial assessment of patient uptake, outcomes, and satisfaction with an integrated discharge monitoring system called Home to Stay. Methods: The intervention was an integrated discharge monitoring system that uses a mobile app platform. Patients downloaded the app prior to discharge from hospital and received a Daily Health Check day #1 to #14, #21, and #30. Patient responses’ were accessed by the health-care team via secure web site, and extreme responses were “flagged” to indicate that a follow-up telephone call was necessary. Primary outcomes were patient uptake, Quality of Recovery scores and satisfaction with the program. Secondary outcomes were 30-day emergency room (ER) visits and readmissions. Results: One hundred and thirty-two patients were invited to participate and 106 accepted. Of these, 93 used the app at least once. The mean overall score on the Quality of Recovery Scale increased significantly from day 1 to day 14. Patient satisfaction with the app was high, with 92% of patients reporting overall satisfaction as good or excellent. The 30-day readmission rate was 6% and was lower than the 30-day readmission rate of 18% reported for the 4 months prior to the start of the study. Conclusions: The Home to Stay Program to support patients at home after colorectal surgery is feasible with high patient uptake and satisfaction. This program has the potential to reduce 30-day readmissions, however further studies are required.
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Haun, Courtney N., Zachary B. Mahafza, Chassidy L. Cook, and Geoffrey A. Silvera. "A Study Examining the Influence of Proximity to Nurse Education Resources on Quality of Care Outcomes in Nursing Homes." INQUIRY: The Journal of Health Care Organization, Provision, and Financing 55 (January 1, 2018): 004695801878769. http://dx.doi.org/10.1177/0046958018787694.
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This examination seeks to determine the influence of proximal density to nurse education resources (nursing schools) on nursing home care quality outcomes in Alabama. Motivated by the social network theory, which highlights the influence of relational closeness on shared resources and values, we hypothesize that nursing homes that have higher levels of nursing education resources within a close proximity will exhibit significantly higher nursing home quality outcomes. As proximal density to nurse education resources increases, the opportunity for nursing homes to build closer, stronger ties increase, leading to higher quality outcomes. We examine this hypothesis via ordered logistic regressions of proximal density measures developed through geographic information systems (GIS) software, nurse education resource data from Johnson & Johnson’s Campaign for Nursing’s Future (n = 37), and nursing home quality outcome data from Centers for Medicare and Medicaid Services’s (CMS) Nursing Home Compare from 2016 (n = 226). The results find that increases in proximal density to nurse education resources have a negative and significant association with nursing home quality outcomes in Alabama. Additional sensitivity analysis, which examines the degree to which the nature of this relationship is sensitive to health care facilities’ location in high-density areas, is offered and confirms principal findings. Because nursing programs generally have stronger ties with hospitals, the findings suggest that the nursing homes in areas with higher nurse education resources may actually face greater competition for nurses.
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ONeil, Brock, Lorinda A. Coombs, Ben Haaland, Jian Ying, Jordan P. McPherson, Anne C. Kirchhoff, Cornelia Ulrich, Jared S. Huber, Anna Catherine Beck, and Kathi Mooney. "Exploring cost and utilization outcomes of Huntsman at Home: Which patients benefit most from a novel oncology hospital at home program?" Journal of Clinical Oncology 40, no. 28_suppl (October 1, 2022): 15. http://dx.doi.org/10.1200/jco.2022.40.28_suppl.015.
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15 Background: We previously demonstrated that Huntsman at Home (HH), a novel oncology hospital at home program, was associated with reduced healthcare utilization and costs. HH was also linked to shorter hospital stays and fewer emergency room (ER) visits. In this study, we sought to understand the impact of HH in specific patient subgroups. Methods: We compared outcomes among 169 patients consecutively admitted to HH against 198 usual care patients. Five dichotomous subgroups were created based upon patient a) sex b) age c) area level median income d) Charlson Comorbidity Index (CCI), and e) current use of systemic therapy (ST). Outcomes included 30-day costs, unplanned hospitalizations (UH), length of hospital stays, and ER visits. HH and usual care were compared via inverse propensity weighted regression models. Treatment propensities were estimated via random forests based on age, race, stage, cancer site, presence of metastases, CCI, and area level median income.Results: The between group difference favoring HH achieved statistical significance (p < 0.05) for at least two out of the four outcomes in each subgroup except for patients with higher comorbid illnesses. While HH participants did not always experience statistically better outcomes than usual care, none of the outcomes examined favored usual care for any subgroup. Sex. Female and male HH patients experienced fewer UH and lower costs than usual care. Male HH patients also had shorter hospital stays and fewer ED visits. Age. When stratifying age at 65 years, older HH patients experienced fewer days in the hospital and fewer UH. Younger HH patients had lower costs, and fewer UH and ED visits. Area level Income. All outcomes were better for high and low income HH patients compared to usual care except for ED visits among those with low income. CCI. Among those with a low CCI score, all four outcomes were better among HH patients. In contrast, differences between groups with higher comorbid illness did not achieve statistical significance for any outcome. Systemic Therapy. HH participants on ST experienced shorter hospital stays and fewer UH compared to usual care. Among those not on ST, HH patients experienced lower costs, and fewer UH and ED admissions. Conclusions: In this exploratory analysis, we found that the utilization and cost benefit associated with HH was robust, favoring better outcomes in each subgroup including lower 30-day costs, shorter hospital length of stay and fewer unplanned hospitalizations or ER visits. While medically complex patients may not receive similar benefit from HH as other subgroups, no outcomes favored patients managed by usual care. Taken together, this suggests that health care utilization and cost reductions associated with HH occur across multiple subgroups, but patients with high comorbidity may require additional intervention to realize lower utilization and costs.
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Ali, Saadia, Marshall J. Getz, and Heather Chung. "Bridging the gap for patients with mental illness." Mental Health Clinician 5, no. 1 (January 1, 2015): 40–45. http://dx.doi.org/10.9740/mhc.2015.01.040.
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A metropolitan hospital system has developed and implemented a transition-of-care program focusing on patients with mental illnesses and high risk for hospital readmissions or emergency department visits. Currently, the transition period between care settings creates a state of vulnerability for patients and their caregivers. Poor care coordination negatively affects patient outcomes and results in a major economic burden. Patients with mental illnesses are particularly sensitive to transition-of-care issues including confusion about which medications to start and stop. This program aims to design, implement, and evaluate interventions to improve care transitions at 3 hospitals for individuals with a primary or secondary psychiatric diagnosis. In the inpatient setting, the clinical pharmacist, nurse practitioners, and social workers collaborate to identify medication-related problems. After patients are discharged from the hospital, nurse practitioners, the clinical pharmacist, and educators follow up with patients for 30 days via home health aide visits and telephone calls. Evidence-based tools and assessments are used to drive the program's interventions. From June 2014 to September 2014, 770 patients were identified as high risk. Readmissions data are pending. The patient outcomes data will fill the gap in the literature with essential information on transition-of-care issues within the mental health population. This program has implications to affect health care policy because it uses multiple evidence-based practices with the ultimate goal of decreasing economic burden for health systems and patients. New pharmacist roles in transition of care may emerge from this program.
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Melvin, Jennifer, James Ramsay, and Julie Vine. "PM467 Review of a Western Australian Hospital in the Home (HiTH) program for bicillin secondary prophylaxis in paediatric patients at risk of recurrent acute rheumatic fever." Global Heart 9, no. 1 (March 2014): e157-e158. http://dx.doi.org/10.1016/j.gheart.2014.03.1788.
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Ross, Jennifer K., Kimberly D. Boeser, Dana Simonson, Malia Hain, Kristi Killelea, and Alison Galdys. "202. Implementation of an Outpatient Parenteral Antimicrobial Therapy (OPAT) Collaborative for Patients with Staphylococcus aureus or Gram-Negative Bacilli Bacteremia Requiring Home Infusion: The PANTHIR Program." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S105. http://dx.doi.org/10.1093/ofid/ofaa439.246.
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Abstract Background Staphylococcus aureus (SA) and Gram-negative bacilli (GNB) bacteremia often require prolonged treatment courses due to high morbidity and mortality risk. Outpatient parenteral antibiotic therapy (OPAT) has emerged as a preferred delivery method. Few data have been published regarding the follow-up and adverse event rates among OPAT patients. We describe outcomes in patients with SA or GNB bacteremia transitioning from an academic medical center to home infusion, prompting the implementation of the Parenteral ANtimicrobial therapy Transitions to Home Infusion Review (PANTHIR) program. Methods A retrospective chart review of adult patients with SA or GNB bacteremia at the University of Minnesota Medical Center requiring home infusion represent a 26-month period. Baseline outcomes, including 30-day hospital readmissions and adverse drug events (ADEs), were calculated. The PANTHIR program was launched as an interdisciplinary collaborative with an infectious diseases (ID) provider, pharmacists, and home infusion specialists. Core program elements include inpatient identification, ID pharmacist review, care plan documentation and communication, and OPAT program measures. Results The retrospective cohort included 69 patients. 23.2% experienced a hospitalization within 30 days of discharge and 26.1% experienced an ADE (Table 1). The mean duration of therapy was 22 days. No patient received aminoglycosides and one required vancomycin. A primary goal was to improve the continuity of care for potentially life-threatening bacteremia during the vulnerable inpatient to outpatient transition. Electronic health record functionality allowed for creation of an OPAT navigator for infectious diseases (ID) pharmacist transition plan documentation, electronic communication with designated provider and home infusion pharmacist, and retrieval of focal data points for ongoing program evaluation. 28 patients have been enrolled in the PANTHIR program with outcomes data collection underway. Table 1. Retrospective data among University of Minnesota Medical Center patients hospitalized with SA or GNB bacteremia requiring home infusion on discharge. Conclusion Hospital readmission rates and ADEs are frequent among patients with SA or GNB bacteremia requiring OPAT via home infusion. An ID pharmacist-directed program in collaboration with an ID provider is feasible for OPAT transitions and may serve as a roadmap for other institutions. Disclosures Dana Simonson, PharmD, BCPS, Janssen (Advisor or Review Panel member, Other Financial or Material Support, Webinar Series Speaker Fall 2019)