Treatment of congestive heart failure in the setting of hospital at home. Study of 158 patients

BACKGROUND AND OBJECTIVE: Hospital at Home might become a suitable alternative to traditional hospital admissions for several exacerbated chronic diseases. Congestive heart failure represents an important workload at the hospital level. In this study we present the results of our experience with congestive heart failure patients attended in Hospital at Home regimen during the period 1999-2001. PATIENTS AND METHOD: In 1999 we initiated a program to refer patients with congestive heart failure to Hospital at Home care. The program was agreed by the departments of emergency, cardiology, internal medicine and hospital at home. During the period 1999-2001, 158 patients (mean age = 76) were attended. Ninety one (58%) were women. At the moment of admission, 103 patients (68%) were on functional status IV of the NYHA. RESULTS: On average, patient's stay on hospital at home was 12,8 days. One hundred and twenty three (78%) of them were discharged, 29 (18%) had to be referred back to conventional hospitalisation and six (4%) died. During the 90 days following the discharge from Hospital at Home, the number of visits to the emergency department and the rate of hospital admissions decreased significantly. CONCLUSIONS: Our data confirm Hospital at Home as a valid option to conventional hospital admission for the management of patients with congestive heart failure.