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  1. Randomised controlled trial comparing effectiveness and acceptability of an early discharge, hospital at home scheme with acute hospital care.

    Article - En anglais

    Objective 

    To compare effectiveness and acceptability of early discharge to a hospital at home scheme with that of routine discharge from acute hospital.

    Design 

    Pragmatic randomised controlled trial.

    Setting 

    Acute hospital wards and community in north of Bristol, with a catchment population of about 224 000 people.

    Subjects 

    241 hospitalised but medically stable elderly patients who fulfilled criteria for early discharge to hospital at home scheme and who consented to participate.

    Interventions 

    Patients'received hospital at home care or routine hospital care.

    Main outcome measures 

    Patients'quality of life, satisfaction, and physical functioning assessed at 4 weeks and 3 months after randomisation to treatment ; length of stay in hospital and in hospital at home scheme after randomisation ; mortality at 3 months.

    Results 

    There were no significant differences in patient mortality, quality of life, and physical functioning between the two arms of the trial at 4 weeks or 3 months.

    Only one of 11 measures of patient satisfaction was significantly different : hospital at home patients perceived higher levels of involvement in decisions.

    Length of stay for those receiving routine hospital care was 62% (95% confidence interval 51% to 75%) of length of stay in hospital at home scheme.

    Conclusions 

    The early discharge hospital at home scheme was similar to routine hospital discharge in terms of effectiveness and acceptability. (...)

    Mots-clés Pascal : Soin intégré, A domicile, Randomisation, Soin intensif, Hôpital, Etude comparative, Facteur efficacité, Acceptabilité sociale, Vieillard, Homme, Critère décision, Angleterre, Grande Bretagne, Royaume Uni, Europe, Organisation santé

    Mots-clés Pascal anglais : Managed care, At home, Randomization, Intensive care, Hospital, Comparative study, Effectiveness factor, Social acceptability, Elderly, Human, Decision criterion, England, Great Britain, United Kingdom, Europe, Public health organization

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0302093

    Code Inist : 002B30A04D. Création : 27/11/1998.