Heart failure and community-acquired pneumonia: cases for home hospital?

BACKGROUND: Home hospital is advocated in many western countries in spite of limited evidence of its economic advantage over usual hospital care. Heart failure and community-acquired pneumonia are two medical conditions which are frequently targeted by home hospital programs. While recent trials were devoted to comparisons of safety and costs, the acceptance of home hospital for patients with these conditions remains poorly described. OBJECTIVE: To document the medical eligibility and final transfer decision to home hospital for patients hospitalized with a primary diagnosis of heart failure or community-acquired pneumonia. DESIGN: Longitudinal study of patients admitted to the medical ward of acute care hospitals, up to the final decision concerning their transfer. SETTING: Medical departments of one university hospital and two regional teaching Swiss hospitals. PATIENTS: All patients admitted over a 9 month period to the three settings with a primary diagnosis of heart failure (n= 301) or pneumonia (n=441). MEASUREMENTS: Presence of permanent exclusion criteria on admission; final decision of (in)eligibility based on medical criteria; final decision regarding the transfer, taking into account the opinions of the family physician, the patient and informal caregivers. RESULTS: While 27.9% of heart failure and 37.6% of pneumonia patients were considered to be eligible from a medical point of view, the program acceptance by family physicians, patients and informal caregivers was low and a transfer to home hospital was ultimately chosen for just 3.8% of heart failure and 9.6% of pneumonia patients. There were no major differences between the three settings. CONCLUSIONS: In the case of these two conditions, the potential economic advantage of home hospital over usual inpatient care is compromised by the low proportion of patients ultimately transferred.

Report on a special investigation of the Nutrition Department of the Northeast Hamilton Community School District for the period August 1, 2013 through June 4, 2014

Report on a special investigation of the Nutrition Department of the Northeast Hamilton Community School District for the period August 1, 2013 through June 4, 2014

Community College Leader Bulletin, Summer 2008, Vol. 1, Issue 2

Newsletter produced by the Iowa Department of Education, Community College unit. This report has information about staff, grants, statistical data, requirements and more.

Community College Leader Bulletin, Fall 2008, Vol. 1, Issue 3

Newsletter produced by the Iowa Department of Education, Community College unit. This report has information about staff, grants, statistical data, requirements and more.

Community College Leader Bulletin, Spring 2009, Vol. 2, Issue 2

Newsletter produced by the Iowa Department of Education, Community College unit. This report has information about staff, grants, statistical data, requirements and more.

Community College Leader Bulletin, Summer 2009, Vol. 2, Issue 3

Newsletter produced by the Iowa Department of Education, Community College unit. This report has information about staff, grants, statistical data, requirements and more.

Community College Leader Bulletin, Fall 2014, Vol. 4, Issue 4

Newsletter produced by the Iowa Department of Education, Community College unit. This report has information about staff, grants, statistical data, requirements and more.

Community College Leader Bulletin, Winter 2013, Vol. 3, Issue 1

Newsletter produced by the Iowa Department of Education, Community College unit. This report has information about staff, grants, statistical data, requirements and more.

Community College Leader Bulletin, Summer 2014, Vol. 3, Issue 3

Newsletter produced by the Iowa Department of Education, Community College unit. This report has information about staff, grants, statistical data, requirements and more.

Community College Leader Bulletin, Winter 2015, Vol. 5, Issue 1

Newsletter produced by the Iowa Department of Education, Community College unit. This report has information about staff, grants, statistical data, requirements and more.

2007-2008 Academic Year Iowa Community Colleges Tuition and Fees Report, July 2007

This document shows the tuition and fees charged by the 15 community colleges. It includes comparisons to the regents institutions and to national data.

2004-2005 Academic Year Iowa Community Colleges Tuition and Fees Report, November 2004

This document shows the tuition and fees charged by the 15 community colleges. It includes comparisons to the regents institutions and to national data.

2006-2007 Academic Year Iowa Community Colleges Tuition and Fees Report, July 2006

This document shows the tuition and fees charged by the 15 community colleges. It includes comparisons to the regents institutions and to national data.

Iowa Community Colleges Tuition and Fees Report 2009, August 2008

This document shows the tuition and fees charged by the 15 community colleges. It includes comparisons to the regents institutions and to national data.

Iowa Community Colleges High School Enrollment Report, February 2006

Community Colleges of Iowa transmit fiscal year enrollment data to the Department of Education. All data included in this report, except where noted, are taken from the Management Information System (MIS) electronic data files and are confirmed by the community college.