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Outcomes Similar for Seniors With Hospital at Home, Admission

TUESDAY, April 20, 2021 -- For older persons who are medically unwell and referred for a hospital admission, admission avoidance hospital at home (HAH) with comprehensive geriatric assessment (CGA) is associated with similar outcomes to hospital admission with CGA, according to a study published online April 20 in the Annals of Internal Medicine.

Sasha Shepperd, D.Phil., from the University of Oxford in the United Kingdom, and colleagues examined the clinical effectiveness of admission avoidance HAH with CGA for 1,055 older persons (mean age, 83.3 years) who were medically unwell and referred for a hospital admission. Participants were randomly assigned in a 2:1 ratio to admission avoidance HAH with CGA versus hospital admission with CGA.

The researchers found that 78.6 percent of participants in the CGA HAH group and 75.3 percent in the hospital admission group were living at home at six-month follow-up (relative risk, 1.05; 95 percent confidence interval, 0.95 to 1.15; P = 0.36). Overall, 16.9 versus 17.7 percent had died (relative risk, 0.98; 95 percent confidence interval, 0.65 to 1.47; P = 0.92) and 5.7 versus 8.7 percent were in long-term residential care (relative risk, 0.58; 95 percent confidence interval, 0.45 to 0.76; P < 0.001).

"A health system that includes admission avoidance HAH with CGA can create additional acute health care capacity for older persons referred for a hospital admission," the authors write.

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