Virtual Hospital Care Functional Outcomes

Virtual hospital care has increased in prevalence over the last several years. And as the overall functional capacity that older persons who are hospitalized become more and more well known, this method of care is getting more and more attention. In a virtual hospital setting, older persons can receive medical care for acute conditions without having to leave their home.

A recent study by Bruce Leff, MD looked at the differences in the functional outcomes patients experience in a virtual hospital setting and in traditional acute hospital care settings. The Comparison of Functional Outcomes Associated with Virtual Hospital Care and Traditional Acute Hospital Care used a survey questionnaire in a nonrandomized clinical trial to identify these differences.

Several variables were looked at in the study. In particular, changes in the activity of daily living scores as well as instrumental activity of daily living scores were both looked at. Factors involved in activities of daily living and instrumental activity of daily living included:

• Eating
• Bathing
• Dressing
• Toileting
• Transferring
• Managing money
• Managing medication
• Shopping
• Light or heavy housework
• Preparing meals
• Using the telephone

These were measured one month before admission into care as well as 2 weeks after admission to either of these care settings. Patients were asked what kind of experience they had with each of the points above, and scores ranged from 0 for fully independent to 28 for fully dependent.

In the virtual hospital care model, patients received daily home visits from a physician, but were not required to have a caregiver in the home at all times. Patients also had intermittent nursing visits on a daily level and provided initial care for a mean of 16.9 hours.

On average, this study found that patients who were treated in a virtual hospital setting had greater improvement in their instrumental activity of daily living than those who received care in a traditional hospital setting. Functional decline was reduced, and a greater number of hospitals at home patients improved and smaller numbers declined. The theory for this is that virtual hospital care minimizes activity restrictions while allowing patients to remain more comfortable and in a familiar environment.

In short, this study found that the use of virtual hospital care, as opposed to acute hospital care, provides very real benefits to older patients who require ongoing care for acute conditions. As such, it is a model of care that should be considered by more care providers.

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