Table 7: Early Versus Late Readmissions in the Hospital-at-Home Group.
| Author, Year | Number of Early Readmissions* (% of total readmissions) |
Number of Late Readmissions* (% of total readmissions) |
Total Number of Readmissions |
|---|---|---|---|
| Cotton et al, 2000 (21) | 6† (50) | 6† (50) | 12 |
| Davies et al, 2000 (20) | 9‡ (24) | 28‡ (76) | 37 |
| Ojoo et al, 2002 (22) | 2§ (17) | 10§ (83) | 12§ |
| Aimonino Ricauda et al, 2008 (19) | 3║ (15) | 17║ (85) | 20║ |
| Shepperd et al, 1998 (15;18) | 1 (13) | 7 (88) | 8 |
| Skwarska et al, 2000 (6) | 9 (25) | 27 (75) | 36 |
Early readmissions were defined as those that occurred before patients were discharged from the hospital-at-home program. Late readmissions were defined as readmissions that occurred after discharge from hospital-at-home and before final follow-up.
The number of patients readmitted early compared with those readmitted late is not specified in the published results. Using the information that the average length of stay in hospital was 3.2 days and the median duration of nurse follow-up was 24 days, and according to Table 3 in the paper, 6 patients in the hospital-at-home group were readmitted to hospital within the first 30 days from the index admission. (21) The study authors were contacted to determine the exact number of early versus late readmissions, but no response has yet been received.
It is unclear from the results whether the 37 patients readmitted to hospital includes the 9 patients readmitted during the first 14 days after randomization, or if this only includes patients readmitted after being discharged from hospital-at-home care. So as not to count these patients twice, it was assumed that the 9 patients were included in this total, resulting in 28 patients being admitted in the late readmission category. The authors were contacted to confirm this assumption, but no response has yet been received.
It is unclear in the published results whether any of the 10 reported readmissions occurred during the hospital-at-home period. Two patients in the hospital-at-home group were, however, excluded from the results of the trial because they were readmitted to hospital as a result of clinical deterioration. Given that the deterioration led to readmission, these 2 patients should have been treated as readmissions rather than excluded from the trial. It was assumed that none of the 10 readmissions reported occurred during the early follow-up period as they would have also been excluded. The authors of the study have been contacted for clarification, but no response has been received to date.
The 3 patients reported as being readmitted before discharge from the hospital-at-home program were readmitted due to failing caregiver health and not the patients’ health. Based on information received from the authors of the study, these 3 patients were not included in the 17 reported readmissions.