Hospital at home as a model of early discharge from hospital [Hospitalización en domicilio como modelo de alta precoz desde el hospital]

ISRCTN	ISRCTN36662318
DOI	https://doi.org/10.1186/ISRCTN36662318
Secondary identifying numbers	SA08I20007

Submission date: 22/05/2009
Registration date: 10/07/2009
Last edited: 03/08/2009

Recruitment status: No longer recruiting
Overall study status: Completed
Condition category: Other

Prospectively registered

Protocol

Statistical analysis plan

Results

Individual participant data

Record updated in last year

Plain English summary of protocol

Not provided at time of registration

Contact information

Dr Gabriel Rada
Scientific

Módulo Universidad Católica
Hospital Dr Sótero del Río
Av. Concha y Toro 3459
Puente, Alto
Santiago
-
Chile

Email	gabriel@rada.cl

Study information

Study design	Single centre randomised masked open study
Primary study design	Interventional
Secondary study design	Randomised controlled trial
Study setting(s)	Hospital
Study type	Quality of life
Participant information sheet	Not available in web format, please use the contact details below to request a patient information sheet
Scientific title	Efficacy, costs and user satisfaction of hospital at home as a model of early discharge from hospital in patients with low and moderate risk [Eficacia, costos y satisfacción usuaria de la hospitalización en domicilio como modelo de alta precoz desde el hospital, en pacientes de riesgo bajo y moderado]
Study objectives	1. Hospital at home is as safe and effective as traditional hospitalisation, in terms of morbidity and mortality 2. Hospital at home does not increase significantly the length of hospitalisation when compared to traditional hospitalisation 3. Hospital at home may decrease the risk of some outcomes associated with traditional hospitalisation (i.e. risk of falls, delirium). Functional recovery and capacity to perform daily activities would be restored in less time and with greater success. 4. Sending patient to hospital at home would release some hospital beds, without increasing the costs 5. User's satisfaction would be higher with hospital at home than with traditional hospitalisation
Ethics approval(s)	Ethics committee of the Dr. Sótero del Río Hospital, SSMSO, Santiago, Chile, gave approval on the 5th January 2009
Health condition(s) or problem(s) studied	Adult inpatients with moderate risk diseases
Intervention	Arm 1 (intervention) - Hospital at home: Subjects assigned to this group will be cared by the hospital at home team (intervention). They will be responsible for providing care (as described under 'intervention characteristics'), deciding on further health care provision (including rehospitalisation) and coordinating future ambulatory treatment. The provision of the intervention will go on until a definitive discharge is decided (this date is considered for the measurement of length of hospitalisation). Arm 2 (control): Subjects assigned to the control group will receive standard care in the hospital. No additional intervention (with the exception of outcome measurements) is considered for this group. Hospital at home team description: The project is based in the Dr. Sótero del Río Hospital, which is the public facility for the nation's most populous districts in Santiago, Chile. The team is composed by gerontologists, nurses, paramedics, kinesiologists and a social assistant. The services provided include: blood tests (all tests available in the hospital, transportation included), X-Ray, intravenous treatment administration, oxygen therapy, nurse care (wound care, catheter management, drainage tubes), secretion aspiration, motor and respiratory rehabilitation.
Intervention type	Other
Primary outcome measure	Length of hospitalisation, measured at discharge (considering both treatments modalities as hospitalisation)
Secondary outcome measures	1. Barthel's Index of Activities of Daily Living, measured at days 0 and 28 2. Confusion Assessment Method for Delirium, measured at days 0 and 7 3. Katz Activities of Daily Living Scale, measured at days 0 and 28 4. Zarit Caregiver Burden Scale, measured at days 0 and 28 5. Pressure ulcers, measured at days 0 and 7 6. Falls, measured at discharge 7. User's satisfaction, measured at discharge 8. Rehospitalisation, measured on day 28, month 3, month 6 9. Emergency department consultations after discharge, measured on day 28, month 3, month 6 10. Mortality, measured on day 28, month 3, month 6
Overall study start date	01/06/2009
Completion date	01/02/2010

Eligibility

Participant type(s)	Patient
Age group	Adult
Sex	Both
Target number of participants	102
Key inclusion criteria	1. Adult inpatients requiring interventions usually provided in the hospital, as health care professionals supervision, intravenous drug administration, oxygen therapy, intensive nursing care or rehabilitation 2. One of the following conditions as the main cause of hospitalisation or as complication of the hospitalisation: 2.1. Surgical procedure 2.2. Pneumonia (community acquired and health-care related) 2.3. Upper urinary tract infection (community acquired and health-care related) 2.4. Septic arthritis 2.5. Acute complications of diabetes 2.6. Decompensated chronic obstructive pulmonary disease 2.7. Decompensated heart failure 2.8. End-stage kidney disease waiting for the initiation of dialysis 2.9. Acute renal failure 2.10. Decompensated liver disease 2.11. Deep vein thrombosis requiring hospitalisation 3. Predicted hospital stay over two days 4. Treating physician agreement with the possibility of the patient being managed under hospital at home modality 5. Responsible caregiver agreement with the possibility of the patient being managed under hospital at home modality 6. Home meeting basic characteristics (space, safety conditions, basic service availability, hygiene in general)
Key exclusion criteria	1. Terminal disease or palliative care 2. Patients requiring intravenous treatments more than twice a day 3. Domestic violence, drug addiction, criminal behaviour, extreme poverty or any other factor that may hamper the normal recovery of patients
Date of first enrolment	01/06/2009
Date of final enrolment	01/02/2010

Locations

Countries of recruitment

Chile

Study participating centre

Módulo Universidad Católica

Santiago
-
Chile

Sponsor information

Pontifical Catholic University of Chile (Pontificia Universidad Católica de Chile) (Chile)
University/education

Avenue Libertador Bernardo O'Higgins 340
Santiago
-
Chile

Website	http://www.puc.cl
"ROR"	https://ror.org/04teye511

Funders

Funder type

Government

National Commission of Scientific Research and Technology, Ministry of Health (Chile) - Fifth National Contest of Projects of Investigation and Development in Health (FONIS 2008) (ref: SA08I20007)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to share	No
IPD sharing plan summary	Not provided at time of registration
Publication and dissemination plan	Not provided at time of registration
IPD sharing plan