Pediatric hospital in the home: clinical outcomes for treatment of a cystic fibrosis respiratory exacerbation

ABSTRACT

Background: Children with cystic fibrosis (CF) have recurrent lung infections and these exacerbation periods have conventionally been treated in hospital. Hospital in the Home (HITH) programs have recently been introduced but equivalence of care has not previously been established.

Objectives: To determine if standardization of treatment (application and frequency) for children with CF during a pulmonary exacerbation would produce equivocal clinical outcomes (lung function and weight), regardless of whether treatment was received in hospital or HITH.

Design and Participants: A retrospective audit was conducted on electronic medical records from 39 children with CF (6–17 years).

Main Outcome measures: Forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), weight and length of stay (LOS) were compared between participants treated either in hospital or under the provision of HITH.

Results: Care provided by HITH was found to be equivalent to hospital-based care (mean difference; 95% CI) for: FEV₁ (0.067; −0.104, 0.238); FVC (0.051; −0.102, 0.204); weight (0.718; −0.251, 1.687); and LOS (−0.781, −2.505, 0.943). All investigated clinical measurements significantly improved (FEV₁ p = .001; FVC p < .001; and weight p < .001) from admission to discharge for both hospital and HITH participants.

Conclusions: HITH appears comparable to hospital provision of care for children with CF during a pulmonary exacerbation in terms of post-treatment outcomes (FEV₁, FVC, weight, and LOS).

KEYWORDS:

• Inpatient stay
• pediatrics
• cystic fibrosis
• home care

Acknowledgments

The authors gratefully acknowledge the following people for their contribution to this study: Tamara Lazzarin and Jenny Murphy for providing expert advice within this field of research, and Dr Michael Steele for his statistical advice.

Conflict of Interest

None to declare.