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Title: Treating acutely ill patients at home: Data from Singapore.
Authors: Ko, Stephanie Q
Goh, Joel
Tay, Yee Kian
Nashi, Norshima 
Hooi, Benjamin MY
Luo, Nan
Kuan, Win Sen 
Soong, John TY
Chan, Derek
Lai, Yi Feng 
Lim, Yee Wei 
Keywords: Home-based
hospital care
internal medicine
public health
Issue Date: Jul-2022
Publisher: Academy of Medicine, Singapore
Citation: Ko, Stephanie Q, Goh, Joel, Tay, Yee Kian, Nashi, Norshima, Hooi, Benjamin MY, Luo, Nan, Kuan, Win Sen, Soong, John TY, Chan, Derek, Lai, Yi Feng, Lim, Yee Wei (2022-07). Treating acutely ill patients at home: Data from Singapore.. Ann Acad Med Singap 51 (7) : 392-399. ScholarBank@NUS Repository.
Abstract: INTRODUCTION: Hospital-at-home programmes are well described in the literature but not in Asia. We describe a home-based inpatient substitutive care programme in Singapore, with clinical and patient-reported outcomes. METHODS: We conducted a retrospective cohort study of patients admitted to a hospital-at-home programme from September 2020 to September 2021. Suitable patients, who otherwise required hospitalisation, were admitted to the programme. They were from inpatient wards, emergency department and community nursing teams in the western part of Singapore, where a multidisciplinary team provided hospital-level care at home. Electronic health record data were extracted from all patients admitted to the programme. Patient satisfaction surveys were conducted post-discharge. RESULTS: A total of 108 patients enrolled. Mean age was 67.9 (standard deviation 16.7) years, and 46% were male. The main diagnoses were skin and soft tissue infections (35%), urinary tract infections (29%) and fluid overload (18%). Median length of stay was 4 (interquartile range 3-7) days. Seven patients were escalated back to the hospital, of whom 2 died after escalation. One patient died at home. There was 1 case of adverse drug reaction and 1 fall at home, and no cases of hospital-acquired infections. Patient satisfaction rates were high and 94% of contactable patients would choose to participate again. CONCLUSION: Hospital-at-home programmes appear to be safe and feasible alternatives to inpatient care in Singapore. Further studies are warranted to compare clinical outcomes and cost to conventional inpatient care.
Source Title: Ann Acad Med Singap
ISSN: 0304-4602
DOI: 10.47102/annals-acadmedsg.2021465
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