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Home Hospitalization for Acute Decompensated Heart Failure: Opportunities and Strategies for Improved Health Outcomes

1
Department of Medicine, University of Illinois at Chicago/Advocate Christ Medical Center, Oak Lawn, 4440 W 95th Street, Suite 131 NOB, Chicago, IL 60453, USA
2
Division of Medical Services, Department of Medicine, Advocate Christ Medical Center, Oak Lawn, Chicago, IL 60453, USA
*
Author to whom correspondence should be addressed.
Healthcare 2018, 6(2), 31; https://doi.org/10.3390/healthcare6020031
Received: 27 January 2018 / Revised: 26 March 2018 / Accepted: 27 March 2018 / Published: 28 March 2018
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PDF [2152 KB, uploaded 3 May 2018]
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Abstract

Importance: Heart failure (HF) is the leading cause of hospitalization among patients over the age of 65 in the United States and developed countries, posing a significant economic burden to the health care systems. More than half of the patients with HF will be readmitted to the hospital within 6 months from discharge, leading not only to increased health care related expenses but also functional decline, iatrogenic injuries and in-hospital infections. With the increasing prevalence of HF, there is a substantial need for innovative delivery care models that can provide hospital level of care at a patient’s home. Observations: Home hospitalization was originally used to safely manage chronically ill patients with general medical (stroke, chronic obstructive pulmonary disease, deep vein thrombosis, community acquired pneumonia) and surgical conditions and was associated with improved patient satisfaction and improvement in activity of daily living status. This had no clear effect on readmission or cost. When hospital at home care model was applied to HF patients it demonstrated increased time to readmission, reduced index costs and improved health related quality of life, with no significant differences in adverse events. Eligible patients should be selected based on multiple factors taking into consideration applicable limitations and comorbidities. Conclusions and Relevance: Providing in-hospital level care to the patient’s house presents a reliable alternative, yielding multiple benefits both for the patient, as well as the health care system. Formulating a well-defined model is necessary before wide implementation. View Full-Text
Keywords: home hospitalization; Acute Decompensated Heart Failure; hospital at home; health outcomes home hospitalization; Acute Decompensated Heart Failure; hospital at home; health outcomes
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Voudris, K.V.; Silver, M.A. Home Hospitalization for Acute Decompensated Heart Failure: Opportunities and Strategies for Improved Health Outcomes. Healthcare 2018, 6, 31.

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