SHM Converge Scientific Abstract ePoster Gallery-Hospital Care at Home Readmission Outcomes in Suburban/Rural Locations

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This study examined 334 Hospital Care at Home (HCAH) episodes involving 298 patients enrolled between January 2021 and February 2023 in Southeast Michigan. The program served a mix of suburban, urban, and rural residents, with slightly more patients living in rural areas (53.7%) than urban areas (46.3%). Most patients were older adults, with a median age of 71 and 64% over age 65.<br /><br />The main goal was to compare 30-day outcomes after discharge for rural versus urban HCAH patients. The study found no significant difference in hospital readmission rates between rural and urban patients: 16.57% for rural patients and 15.69% for urban patients. Likewise, there was no significant difference in emergency department (ED) use within 30 days after discharge: 17.13% for rural patients and 22.22% for urban patients.<br /><br />However, when HCAH patients were compared with the general hospital population, HCAH patients had significantly higher 30-day ED use and readmission rates. ED utilization was 19.46% for HCAH patients versus 14.2% for general hospital patients, and hospital readmission was 16.17% versus 10.56%, respectively.<br /><br />The authors conclude that HCAH appears to provide similar outcomes for rural and urban patients, suggesting it may be a useful model for improving access to acute care in underserved rural areas. At the same time, the higher readmission and ED use rates compared with standard hospital care indicate room for improvement, especially in adapting the program to rural populations. Key limitations include the small sample size, short study period, and restricted geographic scope.

Asset Subtitle

Andrea Huang

Meta Tag

Author List Andrea Huang, Soumya Rangarajan

Category Research

Concept Home-Based Acute Care

Concept Emergency department utilization

Concept Hospital Readmission

Concept Location

Concept Urban Location

Distinguished Non-Finalist

Presenter Organization University of Michigan Ann Arbor

Presenting Author Andrea Huang

Track Transitions of Care

Keywords

Hospital Care at Home

HCAH

rural patients

urban patients

30-day outcomes

hospital readmission

emergency department use

Southeast Michigan

acute care access

older adults

Home-Based Acute Care

Emergency department utilization

Hospital Readmission

Location

Urban Location