Program at home: a Veterans Affairs Healthcare Program to deliver hospital care in the home.
The Portland Veterans Affairs Medical Center (PVAMC) participated in a research-based National Demonstration and Evaluation Study of Hospital at Home Care for Elderly Patients. PVAMC continued hospital at home care in a modified form based on the results of that research phase and feedback from patients, families, and staff. The modified clinical program (referred to as Program @ Home) provided care for the same diagnoses (exacerbation of congestive heart failure, exacerbation of chronic obstructive pulmonary disease, community-acquired pneumonia, cellulitis) but differed from the research-based demonstration project in that it accepted patients of all ages, accepted early-discharge patients from the hospital, and provided a less-intensive physician and nursing model. In the first 42 months, 290 patients were admitted; 23% came from the emergency room, 54% were early hospital discharge, and the remainder came from an outpatient clinic or home care. Average length of stay was 3.2 days, and 37% were younger than 65. The results describe how a home hospital program has been integrated into the clinical care offerings of a managed care health system and how it supports inpatient, primary, emergency, and home care programs.
Mader
Scott L
SL
Veterans Affairs Medical Center, Portland, Oregon 97207, USA. scott.mader@va.gov
Medcraft
Marijo C
MC
Joseph
Carol
C
Jenkins
Kay L
KL
Benton
Nancy
N
Chapman
Kathleen
K
Donius
Maggie A
MA
Baird
Carol
C
Harper
Richard
R
Ansari
Yasmin
Y
Jackson
Jim A
JA
Schutzer
William
W
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D018575:Home Care Services, Hospital-Based / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D014481:United States; D014493:United States Department of Veterans Affairs