scholarly journals Connected care for endocarditis and heart failure patients: a hospital-at-home programme

Author(s):  
J. van Ramshorst ◽  
M. Duffels ◽  
S. P. M de Boer ◽  
A. Bos-Schaap ◽  
O. Drexhage ◽  
...  

Abstract Background Healthcare expenditure in the Netherlands is increasing at such a rate that currently 1 in 7 employees are working in healthcare/curative care. Future increases in healthcare spending will be restricted, given that 10% of the country’s gross domestic product is spent on healthcare and the fact that there is a workforce shortage. Dutch healthcare consists of a curative sector (mostly hospitals) and nursing care at home. The two entities have separate national budgets (€25 bn + €20 bn respectively) Aim In a proof of concept, we explored a new hospital-at-home model combining hospital cure and nursing home care budgets. This study tests the feasibility of (1) providing hospital care at home, (2) combining financial budgets, (3) increasing workforces by combining teams and (4) improving perspectives and increasing patient and staff satisfaction. Results We tested the feasibility of combining the budgets of a teaching hospital and home care group for cardiology. The budgets were sufficient to hire three nurse practitioners who were trained to work together with 12 home care cardiovascular nurses to provide care in a hospital-at-home setting, including intravenous treatment. Subsequently, the hospital-at-home programme for endocarditis and heart failure treatment was developed and a virtual ward was built within the e‑patient record. Conclusion The current model demonstrates a proof of concept for a hospital-at-home programme providing hospital-level curative care at home by merging hospital and home care nursing staff and budgets. From the clinical perspective, ambulatory intravenous antibiotic and diuretic treatment at home was effective in safely achieving a reduced length of stay of 847 days in endocarditis patients and 201 days in heart-failure-at-home patients. We call for further studies to facilitate combined home care and hospital cure budgets in cardiology to confirm this concept.

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
V Umans ◽  
J Van Ramshorst ◽  
S.P.M De Boer ◽  
A.J.C.M Bos-Schaap ◽  
S Walburg

Abstract Background Expenditure in healthcare in the Netherlands is so increasing that currently 1 in 7 employees are working in the health care/cure. Future expansion is under constrain given the 10% of GDP use and shortage of working force.Dutch healthcare consists of a cure section (mostly hospitals) and nursing care@home. Both entities have different national budgets (€25 + €20bln) Methods In a proof of concept, we explored a new Hospital@Home (H@H) model combining hospital cure and home-care budgets in a 800 mi2 district with 850,000 inhabitants. The objective comprises 4 proofs: (1)provide hospital care@home, (2) combine financial budgets (3) increasing working forces by combining teams, (4) increased satisfaction of pts and nursing staff. Results We proofed a joining budgets of the hospital and home-care group for cardiology. The homecare-budget was sufficient to hire 3 nurse practitioners who are trained by the cardiologists and work with 16 home-care cardiovascular nurses for H@H treatment. The hospital budget provided a virtual EHR cardiology ward and supplied the home care-nurses with a nursing app to assess the patients EHR. Budgets were sufficient to obtain the home-heartfailure monitoring application. The cardiology-group developed the H@H program for endocarditis treatment and heartfailure telemonitoring. Clinically, in the first 6 months, 50% of hospitalized endocarditis pts were treated with iv antibiotics@home with an average 16.5 days per pt shorter admission days without complications. 33% of eligible hospitalized heartfailure pts consented for telemonitoring@home while up-titrated on medication. Video-consulting reduced outpatient visits with 75%. Patient satisfaction was 75/100. Conclusion In this proof of concept, the H@H program provided hospital cure at home by merging hospital and home-care nursing staff and ICT budgets. Patient satisfaction score were driven by shorter admissions and less hospital visits. We call for further exploration of efforts to facilitate combined home-care and hospital-cure transmural budgets to confirm this proof of concept. Funding Acknowledgement Type of funding source: None


2009 ◽  
Vol 11 (12) ◽  
pp. 1208-1213 ◽  
Author(s):  
Humberto Mendoza ◽  
María Jesús Martín ◽  
Angel García ◽  
Fernando Arós ◽  
Felipe Aizpuru ◽  
...  

2017 ◽  
Vol 1 (suppl_1) ◽  
pp. 1247-1247
Author(s):  
V. Tibaldi ◽  
A. Ricauda Nicoletta ◽  
M. Rocco ◽  
I. Giovanni Carlo

2006 ◽  
Vol 5 (1) ◽  
pp. 158-159
Author(s):  
J GUILLAMONT ◽  
A SOLE ◽  
S GONZALEZ ◽  
A PEREZITURRIAGA ◽  
C DAVILA ◽  
...  

2021 ◽  
pp. 1-15
Author(s):  
Helena Ross ◽  
Ryan Dritz ◽  
Barbara Morano ◽  
Sara Lubetsky ◽  
Pamela Saenger ◽  
...  

2009 ◽  
Vol 17 (4) ◽  
pp. 11-13
Author(s):  
Michael Ewers
Keyword(s):  

EinleitungPatienten in kritischen Gesundheitssituationen und solche mit therapeutisch-technischem Unterstützungsbedarf sollen auch in Deutschland vermehrt im häuslichen Umfeld versorgt werden. Die Voraussetzungen der als High-Tech Home Care (HTHC) oder Hospital-at-Home (H@H) international bekannten Versorgungsform und die mit dem Transfer der Medizintechnik von der Intensivstation ins Wohnzimmer verbundenen (un-)erwünschten Effekte – besonders für die Nutzer – erfahren aber noch selten die notwendige Aufmerksamkeit.


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