The Impact of a Hybrid Hospital at Home Program in Reducing Subacute Rehabilitation
Ravi R Yadav,1 Mohammed A Mahyoub,1,2 Michael W Capriotti,1 Raul L Berio-Dorta,1 Kacie Dougherty,1 Ajit Shukla1 1Virtua Health, Marlton, NJ, USA; 2Systems Science and Industrial Engineering Department, Binghamton University, Binghamton, NY, USACorrespondence: Ajit Shukla, Virtua Health, 301 Lippinco...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2023-10-01
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| Series: | Risk Management and Healthcare Policy |
| Subjects: | |
| Online Access: | https://www.dovepress.com/the-impact-of-a-hybrid-hospital-at-home-program-in-reducing-subacute-r-peer-reviewed-fulltext-article-RMHP |
| _version_ | 1797643756583780352 |
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| author | Yadav RR Mahyoub MA Capriotti MW Berio-Dorta RL Dougherty K Shukla A |
| author_facet | Yadav RR Mahyoub MA Capriotti MW Berio-Dorta RL Dougherty K Shukla A |
| author_sort | Yadav RR |
| collection | DOAJ |
| description | Ravi R Yadav,1 Mohammed A Mahyoub,1,2 Michael W Capriotti,1 Raul L Berio-Dorta,1 Kacie Dougherty,1 Ajit Shukla1 1Virtua Health, Marlton, NJ, USA; 2Systems Science and Industrial Engineering Department, Binghamton University, Binghamton, NY, USACorrespondence: Ajit Shukla, Virtua Health, 301 Lippincott Dr, Marlton, NJ, USA, 08053, Email ashukla@virtua.orgPurpose: The purpose of this study was to compare health outcomes for patients receiving acute care in their homes through a Hospital at Home (HaH) program to outcomes for inpatients in the traditional hospital setting.Patients and Methods: We compared outcomes for patients in a HaH program at Virtua Health in 2022 (N = 271) to traditional inpatients during the same year (N = 13,776) with the same diagnoses. We defined outcomes as recommendations for subacute rehabilitation (SAR) upon discharge as this recommendation indicates the need for additional therapy based on a physician’s assessment of the patient. Specifically, we searched notes in the electronic medical records for terms related to recommendation for SAR using text mining algorithms and a natural language processing (NLP) model to confirm these recommendations. We then compared the proportion of patients within each group that had a SAR recommendation, and controlled for differences in sample size, age, and diagnosis using bootstrapping analyses.Results: We observed that the proportion of patients in the HaH program that were recommended for SAR (0.148) was significantly different from the proportion of patients who remained in the traditional hospital setting (0.363), with a reduced need for SAR for HaH patients. We obtained qualitatively similar results when we controlled for sample size and diagnosis. Controlling for age yielded an older control population, and the difference in the proportion of patients with SAR recommendations between the groups widened.Conclusion: The reduced need for SAR for HaH patients in this study suggests that HaH programs are a promising alternative care model. Future work may consider how health outcomes vary for patients with different diagnoses, clinical histories and demographics, which may inform how HaH programs operate moving forward.Keywords: managed care, NLP, text mining, short-term rehab, telemedicine |
| first_indexed | 2024-03-11T14:20:37Z |
| format | Article |
| id | doaj.art-a8c89e091abb4a569833b78ed03f6f5a |
| institution | Directory Open Access Journal |
| issn | 1179-1594 |
| language | English |
| last_indexed | 2024-03-11T14:20:37Z |
| publishDate | 2023-10-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Risk Management and Healthcare Policy |
| spelling | doaj.art-a8c89e091abb4a569833b78ed03f6f5a2023-10-31T17:33:54ZengDove Medical PressRisk Management and Healthcare Policy1179-15942023-10-01Volume 162223223587732The Impact of a Hybrid Hospital at Home Program in Reducing Subacute RehabilitationYadav RRMahyoub MACapriotti MWBerio-Dorta RLDougherty KShukla ARavi R Yadav,1 Mohammed A Mahyoub,1,2 Michael W Capriotti,1 Raul L Berio-Dorta,1 Kacie Dougherty,1 Ajit Shukla1 1Virtua Health, Marlton, NJ, USA; 2Systems Science and Industrial Engineering Department, Binghamton University, Binghamton, NY, USACorrespondence: Ajit Shukla, Virtua Health, 301 Lippincott Dr, Marlton, NJ, USA, 08053, Email ashukla@virtua.orgPurpose: The purpose of this study was to compare health outcomes for patients receiving acute care in their homes through a Hospital at Home (HaH) program to outcomes for inpatients in the traditional hospital setting.Patients and Methods: We compared outcomes for patients in a HaH program at Virtua Health in 2022 (N = 271) to traditional inpatients during the same year (N = 13,776) with the same diagnoses. We defined outcomes as recommendations for subacute rehabilitation (SAR) upon discharge as this recommendation indicates the need for additional therapy based on a physician’s assessment of the patient. Specifically, we searched notes in the electronic medical records for terms related to recommendation for SAR using text mining algorithms and a natural language processing (NLP) model to confirm these recommendations. We then compared the proportion of patients within each group that had a SAR recommendation, and controlled for differences in sample size, age, and diagnosis using bootstrapping analyses.Results: We observed that the proportion of patients in the HaH program that were recommended for SAR (0.148) was significantly different from the proportion of patients who remained in the traditional hospital setting (0.363), with a reduced need for SAR for HaH patients. We obtained qualitatively similar results when we controlled for sample size and diagnosis. Controlling for age yielded an older control population, and the difference in the proportion of patients with SAR recommendations between the groups widened.Conclusion: The reduced need for SAR for HaH patients in this study suggests that HaH programs are a promising alternative care model. Future work may consider how health outcomes vary for patients with different diagnoses, clinical histories and demographics, which may inform how HaH programs operate moving forward.Keywords: managed care, NLP, text mining, short-term rehab, telemedicinehttps://www.dovepress.com/the-impact-of-a-hybrid-hospital-at-home-program-in-reducing-subacute-r-peer-reviewed-fulltext-article-RMHPmanaged carenlptext miningshort-term rehabtelemedicine |
| spellingShingle | Yadav RR Mahyoub MA Capriotti MW Berio-Dorta RL Dougherty K Shukla A The Impact of a Hybrid Hospital at Home Program in Reducing Subacute Rehabilitation Risk Management and Healthcare Policy managed care nlp text mining short-term rehab telemedicine |
| title | The Impact of a Hybrid Hospital at Home Program in Reducing Subacute Rehabilitation |
| title_full | The Impact of a Hybrid Hospital at Home Program in Reducing Subacute Rehabilitation |
| title_fullStr | The Impact of a Hybrid Hospital at Home Program in Reducing Subacute Rehabilitation |
| title_full_unstemmed | The Impact of a Hybrid Hospital at Home Program in Reducing Subacute Rehabilitation |
| title_short | The Impact of a Hybrid Hospital at Home Program in Reducing Subacute Rehabilitation |
| title_sort | impact of a hybrid hospital at home program in reducing subacute rehabilitation |
| topic | managed care nlp text mining short-term rehab telemedicine |
| url | https://www.dovepress.com/the-impact-of-a-hybrid-hospital-at-home-program-in-reducing-subacute-r-peer-reviewed-fulltext-article-RMHP |
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