Trial Outcomes & Findings for Rural Home Hospital: Proof of Concept (NCT NCT04531280)

NCT ID: NCT04531280

Last Updated: 2025-01-30

Results Overview

Rural home hospital is when eligible rural patients receive hospital level care at home. This measure includes patients that were hospitalized in rural home hospital for treatment for their acute condition and were discharged from rural home hospital after their treatment was complete. The number in the data table reflects the number of patients that completed their home hospitalization.

• Recruitment status: COMPLETED
• Study phase: NA
• Target enrollment: 7 participants
• Primary outcome timeframe: Day of admission to day of discharge, estimated 10 days later
• Results posted on: 2025-01-30

Participant Flow

A patient may be considered for Rural home hospital care if they are acutely ill at home, present acutely ill to a clinic or emergency department, or if they are admitted and require additional days of acute care. They must meet inclusion and exclusion criteria and be assessed for eligibility by the rural home hospital physician. Clinicians are any member of the rural home hospital clinical team that will be providing care to rural patients that enroll in the intervention.

No significant event occurred after participant enrollment

Participant milestones

Measure	Patients Patients who received the home hospital intervention. Patients receive hospital-level care in their home, as a substitute to traditional hospital care.	Clinicians Clinicians that provide hospital-level care in a patient's home, as a substitute to traditional hospital care. Home hospital care: Patients receive hospital-level care in their home.
Overall Study STARTED	3	4
Overall Study COMPLETED	3	4
Overall Study NOT COMPLETED	0	0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Rural Home Hospital: Proof of Concept

Baseline characteristics by cohort

Measure	Patients n=3 Participants Patients receive hospital-level care in their home, as a substitute to traditional hospital care. Home hospital care: Patients receive hospital-level care in their home.	Clinicians Clinicians that provide hospital-level care in a patient's home, as a substitute to traditional hospital care. Home hospital care: Patients receive hospital-level care in their home.	Total n=3 Participants Total of all reporting groups
Age, Categorical <=18 years	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants
Age, Categorical Between 18 and 65 years	1 Participants n=5 Participants	0 Participants n=7 Participants	1 Participants n=5 Participants
Age, Categorical >=65 years	2 Participants n=5 Participants	0 Participants n=7 Participants	2 Participants n=5 Participants
Age, Continuous	77 years STANDARD_DEVIATION 12 • n=5 Participants	—	77 years STANDARD_DEVIATION 12 • n=5 Participants
Sex: Female, Male Female	3 Participants n=5 Participants	—	3 Participants n=5 Participants
Sex: Female, Male Male	0 Participants n=5 Participants	—	0 Participants n=5 Participants
Race (NIH/OMB) American Indian or Alaska Native	0 Participants n=5 Participants	—	0 Participants n=5 Participants
Race (NIH/OMB) Asian	0 Participants n=5 Participants	—	0 Participants n=5 Participants
Race (NIH/OMB) Native Hawaiian or Other Pacific Islander	0 Participants n=5 Participants	—	0 Participants n=5 Participants
Race (NIH/OMB) Black or African American	0 Participants n=5 Participants	—	0 Participants n=5 Participants
Race (NIH/OMB) White	3 Participants n=5 Participants	—	3 Participants n=5 Participants
Race (NIH/OMB) More than one race	0 Participants n=5 Participants	—	0 Participants n=5 Participants
Race (NIH/OMB) Unknown or Not Reported	0 Participants n=5 Participants	—	0 Participants n=5 Participants
Region of Enrollment United States	3 participants n=5 Participants	—	3 participants n=5 Participants

PRIMARY outcome

Timeframe: Day of admission to day of discharge, estimated 10 days later

Population: Three patients completed a rural home hospitalization. Rural home hospitalized patients were treated for their acute condition in rural home hospital.

Rural home hospital is when eligible rural patients receive hospital level care at home. This measure includes patients that were hospitalized in rural home hospital for treatment for their acute condition and were discharged from rural home hospital after their treatment was complete. The number in the data table reflects the number of patients that completed their home hospitalization.

Outcome measures

Measure	Patients n=3 Participants Patients who received the home hospital intervention. Patients receive hospital-level care in their home, as a substitute to traditional hospital care.	Clinicians Clinicians that provide hospital-level care in a patient's home, as a substitute to traditional hospital care. Home hospital care: Patients receive hospital-level care in their home.
Number of Patients That Completed Their Rural Home Hospitalization	3 Participants	—

SECONDARY outcome

Timeframe: Once, within Day of discharge to 7 days later

Population: Rural home hospitalized patients that completed the discharge survey

This is a hospital level measure of performance that reports the average patient reported quality of preparation for self-care response among adult patients discharged from general acute care hospitals. Data will be collected by a Research Assistant via patient, ( scale of 1 to 12; where 12 indicates highest readiness to transition). The final score is calculated by calculating the sum or responses across the three items ((score Strongly Disagree = 1; Disagree = 2; Agree = 3; Strongly Agree = 4), the number of questions answers are counted, and then the mean response is then calculated (sum divided by count).

Outcome measures

Measure	Patients n=1 Participants Patients who received the home hospital intervention. Patients receive hospital-level care in their home, as a substitute to traditional hospital care.	Clinicians Clinicians that provide hospital-level care in a patient's home, as a substitute to traditional hospital care. Home hospital care: Patients receive hospital-level care in their home.
3-item Care Transition Measure	12 score on a scale Standard Deviation 0	—

SECONDARY outcome

Timeframe: Once, within Day of discharge to 7 days later

Population: Rural home hospitalized patients that completed the discharge survey

The Picker Patient Experience Questionnaire is a fifteen item questionnaire covering eight domains including information & education and coordination of care. The questionnaire is used to measure patient experience with in-patient care. The questions have two ("yes" or "no") to four response options ("yes"," no", "I did not need to", or "yes, to some extent"). Neutral answers, such as "I did not need to", and the most positive answer are coded as a "non-problem" (score = 0). The remaining responses are coded as "problems" (score = 1). A problem is defined as any aspect of health care that could be improved upon. Data will be collected by a research assistant via patient. Scale of 1-15, where a higher score indicates better patient experience.

Outcome measures

Measure	Patients n=1 Participants Patients who received the home hospital intervention. Patients receive hospital-level care in their home, as a substitute to traditional hospital care.	Clinicians Clinicians that provide hospital-level care in a patient's home, as a substitute to traditional hospital care. Home hospital care: Patients receive hospital-level care in their home.
Picker Experience Questionnaire	13 score on a scale Standard Deviation 0	—

SECONDARY outcome

Timeframe: Once, between Day of discharge to 7 days later

Population: Rural home hospitalized patients that completed the discharge survey

Measure of patient experience and satisfaction with care using any number from 0 to 10, where 0 is the worst hospital possible and 10 is the best hospital possible. Data will be collected by a Research Assistant via patient

Outcome measures

Measure	Patients n=1 Participants Patients who received the home hospital intervention. Patients receive hospital-level care in their home, as a substitute to traditional hospital care.	Clinicians Clinicians that provide hospital-level care in a patient's home, as a substitute to traditional hospital care. Home hospital care: Patients receive hospital-level care in their home.
Global Satisfaction: Scale	10 score on a scale Standard Deviation 0	—

SECONDARY outcome

Timeframe: Day of discharge to 30 days later

Population: Only one patient that completed home hospital hospitalization completed a qualitative interview post discharge therefore qualitative data was collected from only one patient. Four clinicians completed qualitative interviews and therefore qualitative data from four clinicians was analyzed.

Perceived acceptability will be assessed qualitatively through post-discharge semi-structured interviews with clinicians, patients, and caregivers.The numbers in the data table reflect the number of patients and clinicians that perceived rural home hospital care to be acceptable.

Outcome measures

Measure	Patients n=1 Participants Patients who received the home hospital intervention. Patients receive hospital-level care in their home, as a substitute to traditional hospital care.	Clinicians n=4 Participants Clinicians that provide hospital-level care in a patient's home, as a substitute to traditional hospital care. Home hospital care: Patients receive hospital-level care in their home.
Perceived Acceptability of RHH Care	1 Participants	4 Participants

SECONDARY outcome

Timeframe: Day of discharge to 30 days later

Population: One patient that completed home hospital hospitalization completed a qualitative interview post discharge therefore qualitative data was collected from only one patient. Four clinicians completed qualitative interviews

Perceived safety, quality of care, caregiver burden will be assessed qualitatively through one post-discharge semi-structured interview with each participating clinician, patient, and caregiver.

The numbers in the data table reflect the number of patients and clinicians that perceived that rural home hospital was safe and that the care provided was of high quality.

Outcome measures

Measure	Patients n=1 Participants Patients who received the home hospital intervention. Patients receive hospital-level care in their home, as a substitute to traditional hospital care.	Clinicians n=4 Participants Clinicians that provide hospital-level care in a patient's home, as a substitute to traditional hospital care. Home hospital care: Patients receive hospital-level care in their home.
Perceived Safety, Quality of Care, Caregiver Burden	1 Participants	4 Participants

SECONDARY outcome

Timeframe: Day of admission to day of discharge, estimated 10 days later

Population: Three patients were enrolled in this study, these patients received the home hospital intervention. Patients receive hospital-level care in their home, as a substitute to traditional hospital care.

If enrolled patient must be discharged from rural home hospital and taken to an acute-care hospital for care. Data to be collected daily by a research assistant via the Registered Nurse or Paramedic

Outcome measures

Measure	Patients n=3 Participants Patients who received the home hospital intervention. Patients receive hospital-level care in their home, as a substitute to traditional hospital care.	Clinicians Clinicians that provide hospital-level care in a patient's home, as a substitute to traditional hospital care. Home hospital care: Patients receive hospital-level care in their home.
Number of Rural Home Hospital Patients Escalated to Hospital for Care	0 Participants	—

SECONDARY outcome

Timeframe: Day of admission to day of discharge, estimated 10 days later

Adverse events include Fall, Delirium, Potentially preventable Venous Thromboembolism (VTE), New pressure ulcer, Thrombophlebitis at peripheral intravenous line (IV) site. Data to be collected daily by a research assistant via the Registered Nurse or Paramedic

Outcome measures

Measure	Patients n=3 Participants Patients who received the home hospital intervention. Patients receive hospital-level care in their home, as a substitute to traditional hospital care.	Clinicians Clinicians that provide hospital-level care in a patient's home, as a substitute to traditional hospital care. Home hospital care: Patients receive hospital-level care in their home.
Number of Patients With an Adverse Event	0 Participants	—

SECONDARY outcome

Timeframe: Day of admission to day of discharge, estimated 10 days later

Any case of unplanned death among enrolled rural home hospital patient.Data to be collected daily by a research assistant via the Registered Nurse or Paramedic

Outcome measures

Measure	Patients n=3 Participants Patients who received the home hospital intervention. Patients receive hospital-level care in their home, as a substitute to traditional hospital care.	Clinicians Clinicians that provide hospital-level care in a patient's home, as a substitute to traditional hospital care. Home hospital care: Patients receive hospital-level care in their home.
Number of Patients With Unplanned Mortality During Admission	0 Participants	—

SECONDARY outcome

Timeframe: Day of admission to day of discharge, estimated 10 days later

Population: Patients that were home hospitalized

Number of clinical lab orders. Data to be collected daily by a research assistant via rural home hospital records

Outcome measures

Measure	Patients n=3 Participants Patients who received the home hospital intervention. Patients receive hospital-level care in their home, as a substitute to traditional hospital care.	Clinicians Clinicians that provide hospital-level care in a patient's home, as a substitute to traditional hospital care. Home hospital care: Patients receive hospital-level care in their home.
Lab Orders, Number	0 lab orders	—

SECONDARY outcome

Timeframe: Day of admission to day of discharge, estimated 10 days later

Population: Patients that were home hospitalized

The number of days enrolled patient is admitted to rural home hospital.Data to be collected daily by a research assistant via rural home hospital records.

Outcome measures

Measure	Patients n=3 Participants Patients who received the home hospital intervention. Patients receive hospital-level care in their home, as a substitute to traditional hospital care.	Clinicians Clinicians that provide hospital-level care in a patient's home, as a substitute to traditional hospital care. Home hospital care: Patients receive hospital-level care in their home.
Length of Stay	5.5 number of days Standard Deviation 0.57	—

SECONDARY outcome

Timeframe: 30-days post-discharge

Unplanned readmission of patient to hospital 30 days post discharge from rural home hospital. Data to be collected by a research assistant via the patient.

Outcome measures

Measure	Patients n=3 Participants Patients who received the home hospital intervention. Patients receive hospital-level care in their home, as a substitute to traditional hospital care.	Clinicians Clinicians that provide hospital-level care in a patient's home, as a substitute to traditional hospital care. Home hospital care: Patients receive hospital-level care in their home.
Unplanned Readmission(s), Number or Patients	0 Participants	—

SECONDARY outcome

Timeframe: 30-days post-discharge

Population: Patients that were home hospitalized

Any Emergency Department (ED) visits 30 days post-discharge from rural home hospital. Data to be collected by a research assistant via the patient

Outcome measures

Measure	Patients n=3 Participants Patients who received the home hospital intervention. Patients receive hospital-level care in their home, as a substitute to traditional hospital care.	Clinicians Clinicians that provide hospital-level care in a patient's home, as a substitute to traditional hospital care. Home hospital care: Patients receive hospital-level care in their home.
ED Visit(s), Number	0 number of ED visits	—

Adverse Events

Patients

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Clinicians

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. David Levine

Brigham and Women's Hospital

Phone: 6177328925

Email: dmlevine@bwh.harvard.edu

Results disclosure agreements

• Principal investigator is a sponsor employee
• Publication restrictions are in place