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Abstract
Objective Service evaluation of an urban ‘Hospital at Home’ service which provides care in patients’ homes that would traditionally be delivered in the hospital setting.
Design Retrospective longitudinal review of routinely collected data recorded contemporaneously for clinical use, analysed to elicit utilisation patterns and service impact.
Setting A paediatric ‘Hospital at Home’ service delivered across two large acute hospitals, treating a total of 4427 patients across both primary and secondary care in South London from January 2018 to June 2022.
Patients Children managed by the Hospital at Home service, aged 0–16 years
Main outcome measures We describe patient outcomes and service performance including data on demographics, diagnoses, referral sources, hospital reattendances and bed day savings.
Results Over the evaluation period, 11 092 bed days were saved as a direct result of this service at a cost of 1.09–1.25 nursing contacts required per bed day. Reattendance to hospital was 11.1% over the study period, however, parent/carer-initiated reattendance resulting in hospital admission was only 2.7%.
Conclusion Hospital at Home services are a policy priority for the English National Health Service because of their potential to reduce admissions to and enable early discharge from hospital. This evaluation provides insight into an urban population of children managed under Hospital at Home care and demonstrates its feasibility and effectiveness. Our novel approach to the analysis of hospital reattendance data may have the potential as a template for future performance analysis of similar services.
- Child Health
- Health services research
- Paediatrics
Data availability statement
Data are available upon reasonable request. All data are available on request.
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Data availability statement
Data are available upon reasonable request. All data are available on request.
Footnotes
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RA-M, AC, KK and CN contributed equally.
Contributors CRC initiated and conceived the project, designed the analyses, monitored the collection and analyses of data and drafted and revised the paper. He is guarantor. LF conceived the project, designed the analyses, collected and cleaned the data, monitored the analyses of data and drafted and revised the paper. RA-M, AC, KK and CN collected and cleaned the data, undertook the analyses and drafted and revised the paper. BA conceived the project, designed the analyses, monitored the collection and analyses of data and revised the paper. RA-M, AC, KK and CN contributed equally to the manuscript: they are listed in alphabetical order but they should be considered as equal authors. We declare that we have no conflicts of interest. There were no specific sources of funding for this evaluation.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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