Home Care for Acute Ill Patients
Dr. Iliffe's editorial (1) point out insufficient information is
provided by randomised trials and need of descriptive studies for
innovative care programs.
We are developing since 1995 a Home Care Program for acute ill patients
(not rehabilitaction) at a general hospital in Argentina.
Two admission criteria were use: social support at home by family or
carers, and not imminent need of intensive care. Our program involved
medical doctors and nurses teams visiting patients every day as in a
typical inpatient Internal Medicine round.
More than 3 000 patients already pass through our program, 75% as an early
discharge from the hospital and 25% without hospital admission. Financial
saving was 50% of inpatient cost.
Medical conditions did not differ from Internal Medicine Department
asmissions; median stays was four days (same than hospital) and mortality
rate 8% (close than hospital).
We did not randomly assigned patients for home care, but select them.
Anyway, this biased patient's subset certenly benefit with care at home,
near the family and with same technology than inpatients.
Juan Pablo Roubicek, MD
Servicio de Internación Domiciliaria
Hospital Privado de Comunidad
Mar del Plata, Argentina
1 Iliffe S. Hospital at home: from red to amber? BMJ 1998; 316: 1761-
Competing interests: No competing interests