Cochrane Summaries

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Services for patients discharged home early

Shepperd S, Doll H, Broad J, Gladman J, Iliffe S, Langhorne P, Richards S, Martin F, Harris R
Published Online: 
10 August 2011

There continues to be, in some countries, more demand for acute care hospital beds than there are beds. One way to free up beds to make room for other people being admitted is to discharge patients home early. But the patients who are discharged still need acute care. Therefore, special home services have been developed. These services are usually provided by a team of health care professionals, such as doctors, nurses and physiotherapists. The team visits the home of people who have been discharged early to provide them with acute hospital care in their homes. 

A review of the effect of services for patients discharged home early was conducted. After searching for all relevant studies, 26 studies were identified. The studies looked at the effect of these services in patients with different types of conditions: patients who had a stroke, patients who had surgery, and elderly patients who had different types of conditions. 

There was insufficient evidence that providing services to people at home after being discharged home early may increase the risk of death or readmission; or adversely effect quality of life or the completion of daily activities (such as dressing or daily chores).  Patients who had a stroke or elderly patients may have less risk of being admitted to residential care if they are discharged home early with hospital at home services. 

Patients may also be more satisfied with their care at home, and at the same time their carers, in most cases, did not report additional burden. However, there is little evidence of cost savings to the health care system of discharging patients home early to hospital at home care.