Outcomes and costs of home hospitalisation compared to traditional hospitalisation for infectious diseases in Israel: a cohort study
Objectives This study aims to evaluate and compare health outcomes and costs between home hospitalisation and traditional hospitalisation for three common diagnoses—cellulitis, urinary tract infection (UTI) and pneumonia.Design A retrospective cohort study.Setting Primary care, nationwide.Participan...
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BMJ Publishing Group
2024-11-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/11/e085347.full |
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| author | Limor Adler Ilan Yehoshua Sharon Baruch Gez Bar Cohen Beatriz Hemo Angela Irony Khaled Abou Houssien Omri Shental Shirley Shapiro Ben David |
| author_facet | Limor Adler Ilan Yehoshua Sharon Baruch Gez Bar Cohen Beatriz Hemo Angela Irony Khaled Abou Houssien Omri Shental Shirley Shapiro Ben David |
| author_sort | Limor Adler |
| collection | DOAJ |
| description | Objectives This study aims to evaluate and compare health outcomes and costs between home hospitalisation and traditional hospitalisation for three common diagnoses—cellulitis, urinary tract infection (UTI) and pneumonia.Design A retrospective cohort study.Setting Primary care, nationwide.Participants 1311 patients in home hospitalisation and 992 in traditional hospitalisation.Interventions The primary intervention is home hospitalisation, compared with traditional hospitalisation. The intervention was performed according to medical considerations by a specialised team, and this study was done retrospectively to evaluate it.Primary and secondary outcome measures Primary measures included healthcare costs, length of hospitalisation, referrals for further medical services and mortality.Results Costs of home hospitalisation were lower compared with traditional hospitalisation (6056 vs 9619 NIS for pneumonia, 6011 vs 9767 NIS for cellulitis, 6466 vs 8552 NIS for UTI and p value<0.05). The length of home hospitalisations was shorter for pneumonia and cellulitis (5.01 vs 6.05 days, p value 0.001 and 5.3 vs 6.1 days, p value<0.001, respectively). Likewise, for pneumonia and cellulitis, home-hospitalised patients had fewer ED referrals 30 days after discharge (13.7% vs 24%, p value<0.001 and 13.5% vs 19.8%, p value 0.002, respectively). No differences were found in recurrent hospitalisation and mortality 7 and 30 days after discharge.Conclusions Primary care physicians should consider home hospitalisation for these diagnoses as an alternative to traditional hospitalisation. Policymakers should encourage Primary care physicians to use home hospitalisation, as it has financial advantages and better health outcomes. |
| format | Article |
| id | doaj-art-2d2ef09e64b54a9cbf7419f05aa5d851 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-2d2ef09e64b54a9cbf7419f05aa5d8512025-08-20T01:52:49ZengBMJ Publishing GroupBMJ Open2044-60552024-11-01141110.1136/bmjopen-2024-085347Outcomes and costs of home hospitalisation compared to traditional hospitalisation for infectious diseases in Israel: a cohort studyLimor Adler0Ilan Yehoshua1Sharon Baruch Gez2Bar Cohen3Beatriz Hemo4Angela Irony5Khaled Abou Houssien6Omri Shental7Shirley Shapiro Ben David8Maccabi Healthcare Services, Tel Aviv, IsraelMaccabi Healthcare Services, Tel Aviv, Tel Aviv, IsraelMaccabi Healthcare Services, Tel Aviv, IsraelFaculty of Health Science, Ben-Gurion University of the Negev, Beer-Sheva, IsraelMaccabi Healthcare Services, Tel Aviv, Tel Aviv, IsraelOno Academic College, Kiryat Ono, IsraelMaccabi Healthcare Services, Tel Aviv, IsraelMaccabi Healthcare Services, Tel Aviv, IsraelMaccabi Healthcare Services, Tel Aviv, IsraelObjectives This study aims to evaluate and compare health outcomes and costs between home hospitalisation and traditional hospitalisation for three common diagnoses—cellulitis, urinary tract infection (UTI) and pneumonia.Design A retrospective cohort study.Setting Primary care, nationwide.Participants 1311 patients in home hospitalisation and 992 in traditional hospitalisation.Interventions The primary intervention is home hospitalisation, compared with traditional hospitalisation. The intervention was performed according to medical considerations by a specialised team, and this study was done retrospectively to evaluate it.Primary and secondary outcome measures Primary measures included healthcare costs, length of hospitalisation, referrals for further medical services and mortality.Results Costs of home hospitalisation were lower compared with traditional hospitalisation (6056 vs 9619 NIS for pneumonia, 6011 vs 9767 NIS for cellulitis, 6466 vs 8552 NIS for UTI and p value<0.05). The length of home hospitalisations was shorter for pneumonia and cellulitis (5.01 vs 6.05 days, p value 0.001 and 5.3 vs 6.1 days, p value<0.001, respectively). Likewise, for pneumonia and cellulitis, home-hospitalised patients had fewer ED referrals 30 days after discharge (13.7% vs 24%, p value<0.001 and 13.5% vs 19.8%, p value 0.002, respectively). No differences were found in recurrent hospitalisation and mortality 7 and 30 days after discharge.Conclusions Primary care physicians should consider home hospitalisation for these diagnoses as an alternative to traditional hospitalisation. Policymakers should encourage Primary care physicians to use home hospitalisation, as it has financial advantages and better health outcomes.https://bmjopen.bmj.com/content/14/11/e085347.full |
| spellingShingle | Limor Adler Ilan Yehoshua Sharon Baruch Gez Bar Cohen Beatriz Hemo Angela Irony Khaled Abou Houssien Omri Shental Shirley Shapiro Ben David Outcomes and costs of home hospitalisation compared to traditional hospitalisation for infectious diseases in Israel: a cohort study BMJ Open |
| title | Outcomes and costs of home hospitalisation compared to traditional hospitalisation for infectious diseases in Israel: a cohort study |
| title_full | Outcomes and costs of home hospitalisation compared to traditional hospitalisation for infectious diseases in Israel: a cohort study |
| title_fullStr | Outcomes and costs of home hospitalisation compared to traditional hospitalisation for infectious diseases in Israel: a cohort study |
| title_full_unstemmed | Outcomes and costs of home hospitalisation compared to traditional hospitalisation for infectious diseases in Israel: a cohort study |
| title_short | Outcomes and costs of home hospitalisation compared to traditional hospitalisation for infectious diseases in Israel: a cohort study |
| title_sort | outcomes and costs of home hospitalisation compared to traditional hospitalisation for infectious diseases in israel a cohort study |
| url | https://bmjopen.bmj.com/content/14/11/e085347.full |
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