How effective is a hospital at home service for people with acute mental illness?
OBJECTIVE
Hospital at home (HAH) services have been developed to replace traditional inpatient care but there is little recent published data about their efficacy. This study evaluates HAH treatment for people with an acute episode of psychiatric illness who would otherwise have been admitted to hospital.


METHODS
The staffing and operation of the service is described, along with admission criteria. Patients could be visited by the HAH team up to three times a day, 7 days a week. Data were collected for 1 year. Demographic data, diagnoses, referral, discharge pathways, and outcomes are presented.


RESULTS
One hundred and eleven people were admitted to HAH. The most common diagnoses were mood disorders and non-affective psychoses. The mean length of stay was 17 days with an average of 22 home visits to each patient. Twenty percent of patients were transferred to inpatient services. For those who completed their treatment with HAH, symptom improvement and length of stay were comparable to inpatient services. There was only one adverse event, an episode of self harm.


CONCLUSIONS
HAH services can provide a safe, effective alternative to inpatient care for suitable patients. Home treatment has the potential to reduce costs, reduce the pressure on inpatient services and provide care that is acceptable to patients and their families.
North East Hospital at Home, Central Northern Adelaide Health Service, Adelaide, SA, Australia.
Rajan
R
Singh
Jacky
J
Rowan
Cassandra
C
Burton
Cherrie
C
Galletly
D000293:Adolescent; D000328:Adult; D003156:Community Mental Health Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D005260:Female; D018575:Home Care Services, Hospital-Based / Q000706:statistics & numerical data*; D006792:House Calls / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation / Q000706:statistics & numerical data