Affiliation:
1. Division of Hospital Internal Medicine Mayo Clinic Florida Jacksonville Florida USA
2. Division of Advanced Care at Home Mayo Clinic Florida Jacksonville Florida USA
3. Division of Clinical Trials and Biostatistics Mayo Clinic Jacksonville Florida USA
4. Division of Hospital Internal Medicine Mayo Clinic Health System Jacksonville Florida USA
Abstract
AbstractBackgroundHospital‐at‐home has become a more recognized way to care for patients requiring inpatient hospitalization. At times, these patients may require escalation of care (transfer from home back to the brick‐and mortar (BAM) hospital for ongoing hospitalization care needs), a process that has not been extensively studied.ObjectiveTo evaluate what patient factors contribute to escalations of care in the hospital‐at‐home delivery model.Designs, Settings, and ParticipantsWe conducted a retrospective review of all patients admitted to Mayo Clinic's Advanced Care at Home (ACH) program from January 1, 2022 to December 31, 2022.InterventionNone.Main Outcomes and MeasuresPatient information was collected via electronic health record including demographic, socioeconomic, and clinical status. The primary outcome was the of occurrence of an escalation.ResultsA total of 904 patients were included, of whom 80 (8.8%) required an escalation of care. In multivariable analysis, risk of an escalation was significantly higher for patients who were married or had a life partner (HR: 1.82, 95% CI: 1.05–3.23, p = .033) for patients admitted with procedure‐related disorders (HR: 2.61, 95% CI: 1.35–5.05, p = .005) and patients with an increased mortality risk score (HR [per each 1–category increase] = 1.86, 95% CI: 1.39–2.50, p < .001).