loading page

Does the Implementation of Children's Hospital in the Home affect Health Outcomes for Children with Chronic Respiratory Conditions? A non-contemporary retrospective cohort comparison study
  • Thomas Senyard,
  • Kelly Weir,
  • Megan Rutherford
Thomas Senyard
Gold Coast Hospital and Health Service

Corresponding Author:[email protected]

Author Profile
Kelly Weir
Gold Coast Hospital and Health Service
Author Profile
Megan Rutherford
Gold Coast Hospital and Health Service
Author Profile

Abstract

Objective To investigate whether the implementation of a Children’s Hospital in the Home (CHITH) service affects clinical and service outcomes for children with chronic respiratory conditions including cystic fibrosis and non-CF bronchiectasis. Study Design A non-contemporary retrospective cohort comparison study. Setting/Patients Children aged between 1 and 17.99 years who were admitted to Gold Coast University Hospital (GCUH) with a chronic respiratory condition for pulmonary optimisation were eligible. Methods A clinical audit was utilised to compare children with chronic respiratory conditions who were admitted to GCUH in (a) the 12 months prior to implementation of CHITH and (b) the 12-month period following the implementation of CHITH. Outcomes of interest included lung function; inpatient length of stay (days); duration on intravenous antibiotics and weight gain. Normally distributed data was compared using the t-test, while non-parametric data was analysed with the Mann-Whitney test. Results Data was analysed from 58 admissions, 27 (46.55%) of which occurred in the 12 months of traditional management and 31 (53.45%) in the 12 months following the implementation of the CHITH service. A statistically significant reduction in inpatient length of stay was noted following implementation of the CHITH service: 14.25 versus 6.0 days (p-value=0.0001). The pre-CHITH cohort had a non-significant mean improvement of 7.625% in their FEV1 (pred%) compared to 9.75% in the CHITH cohort (p-value=0.44). There was no significant difference in the secondary clinical outcomes. Conclusion The CHITH service provided equitable clinical outcomes for children with a chronic respiratory condition whilst significantly reducing inpatient length of stay.