A home from hospital service for older people

Current policy and practice emphasises much more than ever before a need fo r purchasers and providers to reduce appropriately the length of hospital s tay. Consequently, a number of early discharge "schemes" have been develope d. This paper presents the findings from an evaluation of a "home from hosp ital" (HFH) scheme. The HFH service provides a maximum of six weeks' intensive domiciliary care for older people on their discharge from hospital. The aim of the service is to facilitate early discharge from hospital and to assist patients to re gain independence. The study reported here elicited the views and perceptio ns of clients and professionals involved in the HFH scheme about the qualit y, efficiency and effectiveness of the service. Seventy-five patients were discharged from hospital to the HFH scheme durin g a two month period and those who consented to participate in the study we re interviewed after discharge from the HFH service (n = 40). Participants had attended hospital for various conditions but the largest group were fra cture patients. Hospital staff and community based professionals completed a questionnaire about the service. Overall, patients and professionals perceived the HFH scheme as a beneficia l service, though some minor problems existed at an individual level. Clien ts' dependency levels generally decreased during their time on the scheme. Research using a controlled design is necessary in order to draw firm concl usions about the cost-effectiveness of a HFH service. Overall, home-from-ho spital appears to be an effective model of an early discharge scheme worthy of further attention.