Hospital at home for patients with acute exacerbations of chronic obstructive pulmonary disease; will it be an effective home care model?

The current acute care model for COPD is, in general, insufficient for optimal management of the disease.Coordination of services is especially important at the time of the COPD exacerbation,which is characterised by high morbidity,high healthcare utilisation and even worse fragmentation of care.Home care services can offer a great potential for this aim.Hospital-at-home (HAH) care model is feasible, safe,and efficacious for certain patients with selected acute medical illnesses who require acute hospital-level care. Aim: The aim of the present study was to analyze the effectiveness of HAH for patients with COPD exacerbation. Methods: Two hundered and six patients who were admitted to our institution via the emergency department with the diagnosis of COPD exacerbation were included to HAH. Patients were followed up during the year after HAH practise. Hospitalization rates,emergency department,out patient clinic admissions,and hospitalisation days when needed were evaluated before and after one year period of HAH. Results: After one year follow up period of HAH practise hospitalisation rates,emergency department and out patient clinic addmitions, length of hospital stay were decreased.Respectively 40.29% 21.18%, 54.94% and 46.35%. The decreases for all parametres were found statistical significant (p Conclusion: We conclude that integrated care services including home care using the HAH modalities are strongly needed to enhance both health and managerial outcomes. Clinicians should consider this form of management, especially as there is increasing pressure for inpatient beds in Turkey.