TY - JOUR T1 - “HOSPITAL AT HOME” FOR NEURO-MUSCULAR DISEASE PATIENTS WITH RESPIRATORY TRACT INFECTION: A PILOT STUDY. JF - Respiratory Care DO - 10.4187/respcare.02501 SP - respcare.02501 AU - Andrea Vianello AU - Francesca Savoia AU - Emanuela Pipitone AU - Beatrice Nordio AU - Giulia Gallina AU - Luciana Paladini AU - Alessandra Concas AU - Giovanna Arcaro AU - Federico Gallan AU - Elena Pegoraro Y1 - 2013/05/21 UR - http://rc.rcjournal.com/content/early/2013/05/21/respcare.02501.abstract N2 - Background: The “Hospital at home” (HH) model may provide adequate care without an adverse effect on clinical outcome and is generally well-received by users. Our objective was to compare HH and inpatient hospital care for Neuro-Muscular Disease (NMD) patients with Respiratory Tract Infection (RTI). Methods: Design: Prospective randomised controlled trial. Setting: University teaching hospital offering secondary care service to 500,000 patients. Patients: Selected NMD patients with RTI where hospital admission had been recommended after medical assessment. Interventions: HH was provided as an alternative to inpatient admission. Main outcome measures: need for hospitalization, treatment failure, time to recovery, death during the first 3 months following exacerbation, cost of patient care. Results: Among 59 consecutive NMD patients eligible for the study, 53 met the criteria for HH. Twenty-six patients were randomised to home care and 27 to hospital care. No significant differences were found in treatment failure (8/26 vs 13/27, p=0.19), time to recovery (8.9 ± 4.6 vs 9 ± 8.9 days p=0.21) or mortality at three months (3/26 vs 4/27 deaths; p=0.42) between the groups. HH failure was independently correlated with type of NMD (p=0.0037) with an OR of failure of 17.3 (95% CI, 2.1 to infinity) for patients with Amyotrophic Lateral Sclerosis. The total and daily direct cost of patient healthcare was significantly lower for the patients who were successfully treated at home compared to hospitalised individuals. Conclusions: HH is an effective alternative to hospital admission for selected MND patients with RTI. ER -