Observational studyBMJ open2019
Should I stay or should I go? A retrospective propensity score-matched analysis using administrative data of hospital-at-home for older people in Scotland.
Observational study in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Inpatient-level care at home delivered by virtual wards and hospital at home: a systematic review and meta-analysis of complex interventions and their components.BMC medicine · 2024Pooled it
- Acute care models for older people living with frailty: a systematic review and taxonomy.BMC geriatrics · 2023Pooled it
- Real-world outcomes from 2,905 episodes of hospital at home care: a propensity-matched cohort study.Frontiers in digital health · 2026Article
- Protocol for the enhanced management of multimorbid patients with COPD and severe asthma: role of indoor air quality.BMJ open respiratory research · 2025Observational
- The value of admission avoidance: cost-consequence analysis of one-year activity in a consolidated service.Cost effectiveness and resource allocation : C/E · 2024Article
- The outcomes of treatment for homebound adults with complex medical conditions in a hospital-at-home unit in the southern district of Israel.Israel journal of health policy research · 2024Article
- Five years of Hospital at Home adoption in Catalonia: impact, challenges, and proposals for quality assurance.BMC health services research · 2024Article
- Prospective cohort study for assessment of integrated care with a triple aim approach: hospital at home as use case.BMC health services research · 2022Article
- Hospital at Home for Elderly COVID-19 Patients: A Preliminary Report with 100 Patients.Journal of clinical medicine · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
objectivesTo compare the characteristics of populations admitted to hospital-at-home services with the population admitted to hospital and assess the association of these services with healthcare costs and mortality.
designIn a retrospective observational cohort study of linked patient level data, we used propensity score matching in combination with regression analysis.
participantsPatients aged 65 years and older admitted to hospital-at-home or hospital.
interventionsThree geriatrician-led admission avoidance hospital-at-home services in Scotland. OUTCOME MEASURES: Healthcare costs and mortality.
resultsPatients in hospital-at-home were older and more socioeconomically disadvantaged, had higher rates of previous hospitalisation and there was a greater proportion of women and people with several chronic conditions compared with the population admitted to hospital. The cost of providing hospital-at-home varied between the three sites from £628 to £2928 per admission. Hospital-at-home was associated with 18% lower costs during the follow-up period in site 1 (ratio of means 0.82; 95% CI: 0.76 to 0.89). Limiting the analysis to costs during the 6 months following index discharge, patients in the hospital-at-home cohorts had 27% higher costs (ratio of means 1.27; 95% CI: 1.14 to 1.41) in site 1, 9% (ratio of means 1.09; 95% CI: 0.95 to 1.24) in site 2 and 70% in site 3 (ratio of means 1.70; 95% CI: 1.40 to 2.07) compared with patients in the control cohorts. Admission to hospital-at-home was associated with an increased risk of death during the follow-up period in all three sites (1.09, 95% CI: 1.00 to 1.19 site 1; 1.29, 95% CI: 1.15 to 1.44 site 2; 1.27, 95% CI: 1.06 to 1.54 site 3).
conclusionsOur findings indicate that in these three cohorts, the populations admitted to hospital-at-home and hospital differ. We cannot rule out the risk of residual confounding, as our analysis relied on an administrative data set and we lacked data on disease severity and type of hospitalised care received in the control cohorts.
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