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Randomised controlled trial comparing an acute paediatric hospital at home scheme with conventional hospital care

¹ Researcher, Wirral Services for Child Health
² Head of the Clinical Practice Research Unit and Consultant in Public Health Medicine, Wirral Hospital NHS Trust
³ Consultant Paediatrician, Wirral Hospital NHS Trust
⁴ Team Leader, Paediatric Hospital at Home Team, Wirral Hospital NHS Trust
⁵ Senior Research Fellow, Department of Pharmacology and Therapeutics, University of Liverpool
⁶ Senior Research Fellow, Pharmacology and Therapeutics, University of Liverpool
⁷ Reader in Primary Care, Department of Primary Care, University of Liverpool

Correspondence to:
Correspondence to:
Dr M J Maxwell, Head of CPRU, Arrowe Park Hospital, Upton, Wirral CH49 5PE, UK;
sam.sartain{at}whnt.nhs.uk

Aims: To assess the clinical effectiveness of a paediatric hospital at home service compared to conventional hospital care.

Methods: A total of 399 children suffering from breathing difficulty (n = 202), diarrhoea and vomiting (n = 125), or fever (n = 72) were randomised to Hospital at Home or in-patient paediatric care. Main outcome measures were: comparative clinical effectiveness as measured by readmission rate within three months (used as a proxy for parental coping with illness); and length of stay/care and comparative satisfaction of both patients and carers.

Results: Clinical effectiveness of both services was not significantly different. Length of care was one day longer in the Hospital at Home group; however, most parents and children preferred home care.

Conclusions: Hospital at Home is a clinically acceptable form of care for these groups of acute paediatric illness. Readmission rates within three months failed to show any advantage in terms of parental coping. Parents and patients expressed a strong preference for hospital at home.

Keywords: clinical effectiveness; hospital at home; randomised controlled trial

Abbreviations: HAH, hospital at home; HC, hospital care; RCT, randomised controlled trial

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