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首页> 外文期刊>Journal of Health Services Research & Policy >Performance of hospital-at-home after a randomised controlled trial
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Performance of hospital-at-home after a randomised controlled trial

机译：随机对照试验后在家医院的表现

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Objective: To compare the performance of an admission-avoidance hospital-at-home scheme one year after the end of a randomised trial with its performance during the trial. nnMethods: Observational study of patients admitted to the scheme during a period of 12-19 months after the trial ended. In addition to routine data from service records, patients were interviewed at three days, two weeks and three months after admission, using the same instruments as used in the trial. nnResults: All 78 patients admitted to hospital-at-home during the follow-up period were included, and compared with the 95 patients admitted during the trial. The referral rate to hospital-at-home was the same (11 per month) as during the trial. During the trial, patients were randomised to hospital-at-home or hospital, meaning that hospital-at-home worked at about double the trial volume in the post-trial period. Baseline characteristics showed no statistically significant differences except that post-trial patients were less cognitively impaired. There were no statistically significant differences between the groups in survival at two weeks and three months, or in Barthel index, Sickness Impact Profile 68 and Philadelphia Geriatric Morale Scale. Length of stay in hospital-at-home was significantly shorter in the post-trial period (median of five days versus seven, P < 0.001), and more patients received a visit from their general practitioner during the period of admission (54% versus 38%, P = 0.04); otherwise there were no significant differences in process measures. nnConclusion: Apart from working at higher volume and achieving a shorter length of stay, performance of the hospital-at-home scheme a year after the trial ended was little different from that reported during the trial. This is an example of an observational study providing evidence to support the generalisability of trial findings.
机译：目的：比较随机试验结束后一年的避免入院住院计划的效果及其在试验期间的效果。 nn方法：对试验结束后12-19个月内接受该方案的患者进行观察性研究。除了服务记录中的常规数据外，入院后三天，两周和三个月还使用与试验中使用的相同工具对患者进行了访谈。结果：纳入随访期间所有78例在家住院的患者，并将其与试验期间95例住院的患者进行比较。在家中医院的转诊率与试验期间相同（每月11个）。在试验过程中，患者被随机分配到在家或医院就诊，这意味着在家中医院的工作量是审判后时期的两倍。基线特征没有统计学上的显着差异，只是试验后患者的认知障碍较少。两组之间在两周和三个月的生存率，Barthel指数，疾病影响概况68和费城老年医学士气量表上均无统计学差异。试验后在家住院的时间显着缩短（中位数为5天vs 7天，P <0.001），并且在入院期间接受全科医生就诊的患者更多（54％vs 38％，P = 0.04）；否则，工艺措施之间就没有显着差异。结论：除了工作量更大，住院时间更短之外，试验结束后一年的在家医院计划的绩效与试验期间的报告相差无几。这是一项观察性研究的例子，提供了证据来支持试验结果的普遍性。

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