HOSPITAL-CARE AT HOME - AN EVALUATION OF A SCHEME FOR ORTHOPEDIC PATIENTS

We report on an evaluation of the practicality and acceptability of th e 'Going Home Service', an early discharge intensive patient support s cheme for orthopaedic patients in their own homes. Patient outcomes we re assessed in terms of health and functional status and the impact on patient's carers was assessed. Eight-seven patients who were successf ully discharged from the service were compared with 17 patients readmi tted to hospital prior to their discharge from the service, 44 patient s suitable for the service who did not take it up and 15 patients disc harged from hospital traditionally immediately prior to the service be coming operational. Data were collected via face to face semistructure d interviews and note searching. Twenty-six of the patients' informal carers were also interviewed. The majority of patients in all four gro ups were elderly women, readmitted patients being significantly older than those successfully discharged. The readmitted patients were also more likely to have been admitted originally for traumatic surgery and less likely to have been independently mobile prior to the initial ad mission. Hospital length of stay was shorter amongst Going Home Servic e patients than those cared for traditionally, but the total episode o f care was greater. Patients and carers were well satisfied with the s ervice. Although there was no evidence that quality of Life or functio nality were affected by their early discharge, at three months post op eration, there was some evidence that Going Home Service patients were experiencing less pain than those discharged traditionally. This earl y discharge service provided a good quality of health and social care for the majority of patients. However, it did not suit all patients an d a minority were re-admitted. The findings reported here add to those obtained in other settings and highlight new aspects for consideratio n in the planning and delivery of high quality hospital at home scheme s.