A META-ANALYSIS OF HOSPITAL IN THE HOME

This meta-analysis of Hospital- in-the-Home (HITH) compared to in-hospital care identified 61 Randomised Controlled Trials from MEDLINE, Embase, Social Sciences Citation Index, CINAHL, EconLit, PsycINFO and the Cochrane Database of Systematic Reviews. HITH care led to reduced mortality (odds ratio [OR] 0.81;95% CI, 0.69 to 0.95;p = 0.008; 42 RCTs; 6992 patients), readmission rates (OR 0.75;95% CI,0.59 to 0.95;p = 0.02; 41 RCTs; 5372 patients) and cost (mean-difference 1567.11; 95% CI, 2069.53 to 1064.69; p < 0.001; 11 RCTs; 1215 patients). The number needed to treat at home to prevent one death was 50. Mortality data was homogenous, but heterogeneity was observed for readmission rates and cost. HITH had higher patient and carer satisfaction (21/ 22; 6/8 studies respectively); carer burden was nonsignificantly lower (8/11 studies). HITH is associated with reductions in mortality, readmission rates and cost, and increases in patient and carer satisfaction, but no change in carer burden.