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Research Article

How effective is a hospital at home service for people with acute mental illness?

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Pages 512-516 | Published online: 30 Nov 2010
 

Abstract

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.

Method: 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.

ACKNOWLEDGEMENTS

The authors would like to acknowledge the contributions of Judy Tonkin, Julia Trebilcock, Frank Hall and Jenny Cronin.

DISCLOSURE

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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