Knight, T., Harris, C., Shental, O., Mas, M. and Lasserson, Daniel (2021) The provision of hospital at home care : results of a national survey of UK hospitals. International Journal of Clinical Practice . e14814. doi:10.1111/ijcp.14814 (In Press)

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Abstract

Background
Hospital at home (HaH) replicates elements of hospital-based care in the community, to facilitate the safe management of a broad spectrum of acute illness in the patient’s usual environment. The extent to which this model of care has been adopted in the United Kingdom (UK) is unknown.

Methods
The Society for Acute Medicine Benchmarking Audit is a day of care survey undertaken annually within the UK. Participation is open to all hospital in the UK receiving acutely unwell medical patients. A questionnaire is used to collect hospital-level data on the structure and organisation of acute care delivery. The survey included questions designed to quantify the number of hospitals that offered HaH. When present, further questions were asked to clarify the characteristics of the HaH service in terms of workforce, range of diagnostic test and interventions. This information was used to build a picture of HaH service provision at a national scale.

Results
A total of 130 hospitals contributed organisational data to SAMBA19. The capability to refer to a hospital at home service was recognised by 46.9% (n = 61) of units. The majority of these services, 83.3% (n = 50) were nurse-led. The capability to provide a physician review at home was reported in 23.3% (n = 14). The majority of services could provide intravenous antibiotics at home, but access to other simple interventions, such as intravenous diuretics or acute supplemental oxygen, is limited.

Conclusion
At present, few Acute Medical Units in the UK have access to a hospital at home service capable of replicating essential elements of inpatient care. Significant changes to existing acute care organisations and investment in infrastructure are required to establish equal access to hospital-at-home care within the UK.

Item Type:	Journal Article
Subjects:	R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine
Divisions:	Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Community health services for older people -- Great Britain, Home care services -- Great Britain, Older people -- Hospital care -- Great Britain, Older people -- Medical care -- Great Britain, Older people -- Home care -- Great Britain
Journal or Publication Title:	International Journal of Clinical Practice
Publisher:	Wiley
ISSN:	1368-5031
Official Date:	2021
Dates:	Date Event 2021 Published 12 September 2021 Available 3 September 2021 Accepted
Article Number:	e14814
DOI:	10.1111/ijcp.14814
Status:	Peer Reviewed
Publication Status:	In Press
Publisher Statement:	"This is the peer reviewed version of the following article: Knight, T., Harris, C., Mas, M., Shental, O., Ellis, G. and Lasserson, D. (2021), The provision of hospital at home care: results of a national survey of UK hospitals. International Journal of Clinical Practice. Accepted Author Manuscript e14814, which has been published in final form at https://doi.org/10.1111/ijcp.14814. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions."
Access rights to Published version:	Restricted or Subscription Access
Related URLs:	Publisher

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