ArticleAging clinical and experimental research2026
Hospital at home for older frequent hospital users: present and future of a healthcare challenge.
Article in Aging clinical and experimental research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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15 authors.
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Abstract
backgroundFrequent hospital users (FHUs) show high risk of clinical instability. A hospital-at-home (HaH) service (“GIROT”) was created in Florence, Italy, to reduce hospitalizations in older adults vulnerable to hospital-related complications.
aimTo investigate the association of frequent hospital use with all-cause mortality and hospitalization among HaH patients.
methodspatients referred to GIROT between January 2022 and March 2024, participated in a prospective longitudinal study. Participants were stratified by prior-year hospital admissions (0–1, 2, and 3+) and FHUs were defined based on the association between admissions and risks of subsequent hospitalization and mortality. Multivariate Cox regression assessed the independent association between FHU status and outcomes.
resultsAmong 219 patients (mean age 85.9, 55% female, 44% with severe disability), the median number of hospitalizations in the previous year was 2. Over a 6-month follow-up, mortality risk was 43% and hospitalization risk was 39%. Six-month mortality was higher in subjects with 2 (58%) and 3 + admissions (48%) versus 0–1 admissions (32%), with similar patterns for hospitalization. These findings led to defining FHUs as individuals with 2 + prior hospitalizations. Shorter time-to-death was independently associated with weight loss, severe disability, heart failure with reduced ejection fraction (HFrEF), and FHU status (adjHR 1.49, 95%CI 1.00-2.21). Time-to-hospitalization was independently predicted by HFrEF and FHU status (adjHR 1.80, 95%CI 1.08–3.01).
conclusionsFHUs (i.e., 2 + hospitalizations in the previous year) showed an increased risk of re-admission and mortality among older adults receiving HaH. Extra-hospital care pathways, including HaH and palliative care, may help reduce admissions in this population.
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