Background <p>Hospital at home (HaH) programs have demonstrated safety and efficiency in medical processes; however, few studies have examined their impact on surgical processes. This study aims to explore the feasibility and outcomes of the HaH program in postoperative bariatric surgery.</p> Methods <p>An exploratory retrospective study was conducted on patients undergoing bariatric surgery from March 1, 2021, to February 29, 2024. This study compared the outcomes of patients with conventional hospitalization (Hospital group) with those of patients who underwent early transfer to HaH (Hospital + HaH group). Propensity score matching, adjusted for confounding factors, was used to select the analyzed sample.</p> Results <p>A total of 687 patients who underwent bariatric surgery were identified. HaH was used in 231 patients (33.6%). After propensity score matching, 426 cases were included in the analysis: 207 from the Hospital group and 209 from the Hospital + HaH group. There were no statistically significant differences between the two groups in the rate of postoperative complications (<i>p</i> = 0.236), readmission 30 days after discharge (<i>p</i> = 1), and emergency consultation 30 days after discharge (<i>p</i> = 0.43). The total stay was longer in the Hospital group than in the Hospital + HaH group (2.4 ± 1.37 vs. 2.01 ± 0.1 days, <i>p</i> &lt; 0.001). No patient was transferred from home to the hospital in the Hospital + HaH group. No mortality was reported in either group. A post hoc power calculation was 0.36.</p> Conclusions <p>HaH was associated with similar outcomes to those of conventional hospitalization, but statistical equivalence could not be demonstrated due to limited power. This study supports the feasibility of the HaH program in bariatric surgery, but confirmatory trials are needed.</p>

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Hospital at Home for Early Home Transfer after Bariatric Surgery: A Propensity-Score Matched Study

  • Nils Jimmy Hidalgo,
  • Irene Bachero,
  • Paula González-Atienza,
  • Victor Holguín,
  • David Nicolás,
  • Ainitze Ibarzabal

摘要

Background

Hospital at home (HaH) programs have demonstrated safety and efficiency in medical processes; however, few studies have examined their impact on surgical processes. This study aims to explore the feasibility and outcomes of the HaH program in postoperative bariatric surgery.

Methods

An exploratory retrospective study was conducted on patients undergoing bariatric surgery from March 1, 2021, to February 29, 2024. This study compared the outcomes of patients with conventional hospitalization (Hospital group) with those of patients who underwent early transfer to HaH (Hospital + HaH group). Propensity score matching, adjusted for confounding factors, was used to select the analyzed sample.

Results

A total of 687 patients who underwent bariatric surgery were identified. HaH was used in 231 patients (33.6%). After propensity score matching, 426 cases were included in the analysis: 207 from the Hospital group and 209 from the Hospital + HaH group. There were no statistically significant differences between the two groups in the rate of postoperative complications (p = 0.236), readmission 30 days after discharge (p = 1), and emergency consultation 30 days after discharge (p = 0.43). The total stay was longer in the Hospital group than in the Hospital + HaH group (2.4 ± 1.37 vs. 2.01 ± 0.1 days, p < 0.001). No patient was transferred from home to the hospital in the Hospital + HaH group. No mortality was reported in either group. A post hoc power calculation was 0.36.

Conclusions

HaH was associated with similar outcomes to those of conventional hospitalization, but statistical equivalence could not be demonstrated due to limited power. This study supports the feasibility of the HaH program in bariatric surgery, but confirmatory trials are needed.