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Do people recover from exacerbations of chronic obstructive pulmonary disease (COPD) better in their own home than in the hospital emergency room?

Jeppesen E, Brurberg KG, Vist GE, Wedzicha JA, Wright JJ, Greenstone M, Walters JAE
Published Online: 
16 May 2012

People recovering from an exacerbation of COPD have traditionally done so in hospital. We wanted to find out if peoples' recovery could be aided by treating them at home. So called "hospital at home" support is where a person is sent home and looked after by a specialist respiratory nurse under the guidance of a hospital medical team. People receive regular scheduled visits from the nurse as well as additional visits as requested by the patient and these visits continue until the person has made a full recovery and is discharged from care.

We found eight trials on 870 people comparing hospital at home with  hospital care. The results from these trials show that fewer people are readmitted to hospital if they received their care at home. There was no significant difference in quality of life, although patients and carers said they preferred treatment at home. There was no significant difference in the number of deaths. These results are only applicable to a subgroup of patients who could be treated at home, but for a majority of the patients with acute COPD exacerbations, "hospital at home" schemes are probably not an suitable option.