Program at Home: A Veterans Affairs Healthcare Program to Deliver Hospital Care in the Home
Identifieur interne : 004329 ( Main/Exploration ); précédent : 004328; suivant : 004330Program at Home: A Veterans Affairs Healthcare Program to Deliver Hospital Care in the Home
Auteurs : Scott L. Mader [États-Unis] ; Marijo C. Medcraft [États-Unis] ; Carol Joseph [États-Unis] ; Kay L. Jenkins [États-Unis] ; Nancy Benton [États-Unis] ; Kathleen Chapman [États-Unis] ; Maggie A. Donius [États-Unis] ; Carol Baird [États-Unis] ; Richard Harper [États-Unis] ; Yasmin Ansari [États-Unis] ; Jim A. Jackson [États-Unis] ; William Schutzer [États-Unis]Source :
- Journal of the American Geriatrics Society [ 0002-8614 ] ; 2008-12.
English descriptors
- Teeft :
- Acute care, Acute hospital, Acute hospital admission, Acute illness, Additional cost, Admission process, American geriatrics society, Caregiver satisfaction, Clinical program, Complex patients, Congestive heart failure, Daily nursing visits, Daily physician oversight, Early discharge, Elderly patients, Emergency department, Emergency room, Evaluation study, Family members, Functional outcomes, Geriatr, Greater patient satisfaction, Hartford foundation, Healthcare, Healthcare systems, Home care, Home care nurses, Home care program, Home hospital, Home hospital care, Home hospital program, Hospital admission, Hospital care, Inpatient, Inpatient ward, Intravenous, Intravenous medications, Intravenous therapy, Laboratory results, Leff, Mader, Many patients, Medical center, Medication, Multicomponent intervention, National demonstration, Older patients, Older persons, Outpatient, Outpatient clinic, Oxygen therapy, Previous studies, Program home, Program home discharge, Program home physician, Provider, Pulmonary disease, Pvamc, Randomized trial, Readmission rate, Research year, Shorter length, Urinary tract infection, Usual care, Veteran patients, Veterans affairs, Wound care, Younger patients.
Abstract
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.
Url:
DOI: 10.1111/j.1532-5415.2008.02006.x
Affiliations:
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Medcraft</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Oregon</region></placeName><wicri:cityArea>From the*Veterans Affairs Medical Center, Portland, Oregon†Department of Medicine‡School of Nursing, Oregon Health & Science University, Portland</wicri:cityArea></affiliation></author><author><name sortKey="Joseph, Carol" sort="Joseph, Carol" uniqKey="Joseph C" first="Carol" last="Joseph">Carol Joseph</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Oregon</region></placeName><wicri:cityArea>From the*Veterans Affairs Medical Center, Portland, Oregon†Department of Medicine‡School of Nursing, Oregon Health & Science University, Portland</wicri:cityArea></affiliation></author><author><name sortKey="Jenkins, Kay L" sort="Jenkins, Kay L" uniqKey="Jenkins K" first="Kay L." last="Jenkins">Kay L. Jenkins</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Oregon</region></placeName><wicri:cityArea>From the*Veterans Affairs Medical Center, Portland, Oregon†Department of Medicine‡School of Nursing, Oregon Health & Science University, Portland</wicri:cityArea></affiliation></author><author><name sortKey="Benton, Nancy" sort="Benton, Nancy" uniqKey="Benton N" first="Nancy" last="Benton">Nancy Benton</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Oregon</region></placeName><wicri:cityArea>From the*Veterans Affairs Medical Center, Portland, Oregon†Department of Medicine‡School of Nursing, Oregon Health & Science University, Portland</wicri:cityArea></affiliation></author><author><name sortKey="Chapman, Kathleen" sort="Chapman, Kathleen" uniqKey="Chapman K" first="Kathleen" last="Chapman">Kathleen Chapman</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Oregon</region></placeName><wicri:cityArea>From the*Veterans Affairs Medical Center, Portland, Oregon†Department of Medicine‡School of Nursing, Oregon Health & Science University, Portland</wicri:cityArea></affiliation></author><author><name sortKey="Donius, Maggie A" sort="Donius, Maggie A" uniqKey="Donius M" first="Maggie A." last="Donius">Maggie A. 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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.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Oregon</li></region></list><tree><country name="États-Unis"><region name="Oregon"><name sortKey="Mader, Scott L" sort="Mader, Scott L" uniqKey="Mader S" first="Scott L." last="Mader">Scott L. Mader</name></region><name sortKey="Ansari, Yasmin" sort="Ansari, Yasmin" uniqKey="Ansari Y" first="Yasmin" last="Ansari">Yasmin Ansari</name><name sortKey="Baird, Carol" sort="Baird, Carol" uniqKey="Baird C" first="Carol" last="Baird">Carol Baird</name><name sortKey="Benton, Nancy" sort="Benton, Nancy" uniqKey="Benton N" first="Nancy" last="Benton">Nancy Benton</name><name sortKey="Chapman, Kathleen" sort="Chapman, Kathleen" uniqKey="Chapman K" first="Kathleen" last="Chapman">Kathleen Chapman</name><name sortKey="Donius, Maggie A" sort="Donius, Maggie A" uniqKey="Donius M" first="Maggie A." last="Donius">Maggie A. Donius</name><name sortKey="Harper, Richard" sort="Harper, Richard" uniqKey="Harper R" first="Richard" last="Harper">Richard Harper</name><name sortKey="Jackson, Jim A" sort="Jackson, Jim A" uniqKey="Jackson J" first="Jim A." last="Jackson">Jim A. Jackson</name><name sortKey="Jenkins, Kay L" sort="Jenkins, Kay L" uniqKey="Jenkins K" first="Kay L." last="Jenkins">Kay L. Jenkins</name><name sortKey="Joseph, Carol" sort="Joseph, Carol" uniqKey="Joseph C" first="Carol" last="Joseph">Carol Joseph</name><name sortKey="Medcraft, Marijo C" sort="Medcraft, Marijo C" uniqKey="Medcraft M" first="Marijo C." last="Medcraft">Marijo C. Medcraft</name><name sortKey="Schutzer, William" sort="Schutzer, William" uniqKey="Schutzer W" first="William" last="Schutzer">William Schutzer</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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