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Table 12 Characteristics of studies included in detail

From: Indicators of home-based hospitalization model and strategies for its implementation: a systematic review of reviews

Author, year, country Type of reviews or designs No. of studies Study country Population Intervention Outcomes AMSTAR
Cool et al. [53], 2018, Belgium Systematic review
Mixed
5 RCT*
2 nRCT*
7 single-arm prospective trials
2 qualitative studies
1 retrospective cohort study
European countries, mostly France and United Kingdom (UK)
Other studies from: Belgium, Israel, Germany, Ireland, Spain, Switzerland, Sweden, Australia, Canada, and United States of America (USA)
Adult patients Parenteral cancer drug administration in hospital at home care Quality of life, patient’s satisfaction, safety, and costs Moderate quality review
Corral Gudino et al. [54], 2017, Spain Systematic review
Qualitative
21 RCTs, among which 4 RCTs about HBH Spain Not specified Interventions supporting continuity of care, including HBH Number of readmissions, mortality, or improvement in functional capacity Moderate quality review
Goncalves-Bradley et al. [22], 2017, UK Systematic review and meta-analysis
Quantitative
32 RCTs A majority of studies are from the UK, Australia, and Norway. Other studies from: Canada, Chile, Italy, New Zealand, Spain, Sweden, Thailand, The Netherlands, and Turkey Patients aged 18 years and over, acute episode of care Early discharge hospital at home Effectiveness and cost of the intervention High quality review
Huntley et al. [55], 2017, UK Systematic review
Qualitative
10 RCTs
9 nRCTs
Among them 11 studies (6 RCTs and 5 nRCTs) about HBH
European countries, principally UK Patients aged over 65 years at risk of an unplanned admission Any community-based intervention offered as an alternative to admission to an acute hospital Reduction in secondary care use, patient-related outcomes, safety, and costs Moderate quality review
Shepperd et al. [24], 2016a, UK Systematic review and meta-analysis
Quantitative
3 RCTs
1 nRCT
Norway, UK, and USA People aged 18 years and older, who would otherwise require hospital or hospice inpatient end-of-life care Home-based end-of-life care Place of death, unplanned/precipitous admission to or discharge from hospital, control of symptoms, delay in care from point of referral to intervention, participant health outcomes, family- or caregiver-reported symptoms, family or caregiver unable to continue caring, participant’s preferred place of death, health service use, including system and caregiver costs High quality review
Shepperd et al. [25], 2016b, UK Systematic review and meta-analysis
Quantitative
16 RCTs Australia, Italy, New Zealand, Romania, Spain, UK, and USA Patients aged 18 years and over (older patients = 65 years and older). Patients to be clinically stable and not requiring specialist diagnostic investigation or emergency interventions Hospital at home Mortality, transfer (or readmission) to hospital, functional status, quality of life or self-reported health status, cognitive function, depression, clinical outcomes, place of residence at follow-up (living in a residential setting), patient satisfaction, caregiver outcomes, health professionals’ views, length of stay in hospital and hospital at home, cost, use of other health services and informal care High quality review
Echevarria et al. [23], 2016, UK Systematic review and meta-analysis
Quantitative
7 RCTs UK, Netherlands, Australia, Italy Patients with acute exacerbation of chronic obstructive pulmonary disease Early supported discharge (ESD) and hospital at home (HAH) Structure of ESD/HAH schemes, number of patients experiencing one or more readmissions, mortality and cost, comparing cost across different countries and healthcare structures Moderate quality review
Qaddoura et al. [49], 2015, Canada Systematic review and meta-analysis
Quantitative
3 RCTs
3 nRCTs
among which 5 studies (3 RCTs and 2 nRCTs) are about HBH
Spain, Italy, Sweden Patients who required hospitalization for decompensated heart failure Substitutive care models Mortality, hospital readmissions, other clinical, patient-centered, and cost outcomes High quality review
Caplan et al. [20], 2012, Australia Systematic review and meta-analysis
Quantitative
61 RCTs
among which 26 RCTs about HBH
Countries are not explicitly mentioned Patients aged > 16 years Hospital at home care models regardless of temporal-, team- and disease-specific frameworks Mortality, readmission rates, patient and carer satisfaction, and costs Moderate quality review
Jeppesen et al. [12], 2012, Norway Systematic review and meta-analysis
Quantitative
8 RCTs Australia, Denmark, Italy, Spain, UK Patients with a diagnosis of COPD with an acute exacerbation Hospital at home care Readmission rate, mortality, costs and days of care provision High quality review
Hansson et al. [50], 2011, Denmark Systematic review
Quantitative
1 RCT
1 control group
3 studies had no true control group
USA, Canada, and Italy Children and adolescents aged 0–18 years with a cancer diagnosis Medical treatments relevant for childhood cancer provided by hospital- or community-based healthcare professionals who take an active part in the care in the patient’s own home as an alternative to a hospital admission Children’s physical health, adverse events, parental and child satisfaction, QOL of children and their parents, and costs of using hospital data, questionnaires, or satisfaction surveys Low quality review
Shepperd et al. [51], 2009, UK Systematic review and meta-analysis
Quantitative
26 RCTs Countries are not explicitly mentioned Patients aged 18 years and over (older patients = 65 years and older).
People requiring long-term care needs were not included unless they required admission to hospital for an acute episode of care
Early discharge hospital at home Mortality, readmissions, general and disease-specific health status, functional status, psychological well-being, clinical complications, patient satisfaction, carer satisfaction, carer burden, staff views, discharge destination from hospital at home, length of stay in hospital and hospital at home, cost Moderate quality review
Shepperd et al. [52], 2008, UK Systematic Review and Meta-Analysis Quantitative 10 RTCs Australia, Italy, New Zealand and the UK Patients aged 18 years and older entered the program directly from the community or from the emergency department Hospital care at home Mortality, readmissions or transfers to hospital, general and disease-specific health status, functional status, psychological well-being, clinical complications, patient and caregiver satisfaction, caregiver burden, staff perspectives, place of residence at followup, length of stay and cost Moderate quality review
Felix et al. [26], 2004, UK Systematic review and meta-analysisQuantitative 7 RTCs Spain, Australia (not explicitly mentioned other countries included) Adult patients attending an emergency department with an acute exacerbation within 72 h of presenting to the department and after an Hospital at home schemes Mortality and readmission Moderate quality review
Shepperd et al. [44], 1998, UK Systematic review
Quantitative
5 RCTs UK, USA Patients aged 18 years and over needing treatment during an acute episode of care Hospital at home care Mortality, clinical complications, re-admissions, costs, hospital days saved from the provision of hospital at home, discharge destination from hospital at home, functional status, psychological well-being, patient satisfaction, and carer satisfaction Low quality review
  1. *Legend: Randomized controlled trial (RTC) and Non-randomized controlled trial (nRTC)